Family planning providers' experiences and perceptions of long-acting reversible contraception in Lilongwe, Malawi. Tapika Mwafulirwa, Michele S. O'Shea, Gloria Hamela, Emilia Samuel, Christine Chingondole, Virginia Chipangula, Mina C. Hosseinipour, Jennifer H. Tang ...
Tumlinson, Katherine; Okigbo, Chinelo C; Speizer, Ilene S
A better understanding of the prevalence of service provider-imposed barriers to family planning can inform programs intended to increase contraceptive use. This study, based on data from urban Kenya, describes the frequency of provider self-reported restrictions related to clients' age, parity, marital status, and third-party consent, and considers the impact of facility type and training on restrictive practices. Trained data collectors interviewed 676 service providers at 273 health care facilities in five Kenyan cities. Service providers were asked questions about their background and training and were also asked about age, marital, parity, or consent requirements for providing family planning services. More than half of providers (58%) reported imposing minimum age restrictions on one or more methods. These restrictions were commonly imposed on clients seeking injectables, a popular method in urban Kenya, with large numbers refusing to offer injectables to women younger than 20 years. Forty-one percent of providers reported that they would not offer one or more methods to nulliparous women and more than one in four providers reported that they would not offer the injectable to women without at least one child. Providers at private facilities were significantly more likely to impose barriers, across all method types, and those without in-service training on family planning provision had a significantly higher prevalence of imposing parity, marital, and consent barriers across most methods. Programs need to address provider-imposed barriers that reduce access to contraceptive methods particularly among young, lower parity, and single women. Promising strategies include targeting private facility providers and increasing the prevalence of in-service training. Copyright © 2015 Elsevier Inc. All rights reserved.
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.
Halsall, Viannella; Rogers, Jennifer; Witt, Jacki; Song, Sejun; Nguyen, Hoang Duc Huy; Kelly, Patricia
To provide an overview of lessons learned during the development process of an app for iOS and Android based on national recommendations for providing quality family planning services. After a review of existing apps was conducted to determine whether an app of clinical recommendations for family planning existed, a team of clinicians, training specialists, and app developers created a resource app by first drafting a comprehensive content map. A prototype of the app was then pilot tested using smart tablets by a volunteer convenience sample of women's healthcare professionals. Outcomes measured included usability, acceptability, download analytics, and satisfaction by clinicians as reported through an investigator-developed tool. Sixty-nine professionals tested a prototype of the app, and completed a user satisfaction tool. Overall, user feedback was positive, and a zoom function was added to the final version as a result of the pilot test. Within 3 months of being publicly available, the app was downloaded 677 times, with 97% of downloads occurring on smart phones, 76% downloads occurring on iOS devices, and 24% on Android devices. This trend persisted throughout the following 3 months. Clinicians with an interest in developing an app should consider a team approach to development, pilot test the app prior to wider distribution, and develop a web-based version of the app to be used by clinicians who are unable to access smart devices in their practice setting.
AJRH Managing Editor
. Future efforts to ... Keywords: Family planning, long-acting reversible contraception, Malawi. Résumé. Moins de 2% ..... OCP=oral contraceptive pills; IUC=intrauterine contraception; BTL=bilateral tubal ligation; EC=emergency contraception.
Mugisha, John Frank; Reynolds, Heidi
Provider perspectives on the quality of family planning services have been overlooked in quality of care research and interventions. This qualitative study was carried out in four districts in Uganda, a country where lack of access to quality family planning services remains a challenge. Using four focus group discussions, 16 provider in-depth interviews and nine manager in-depth interviews, this study documented providers' perceptions of quality of care and of barriers to quality services at the organisational and societal levels. To guide study development, analysis and interpretation, the authors relied on an ecological framework where providers' abilities are shaped by the larger organisational and societal environments in which providers live and work. Providers felt that organisational factors, such as supply availability, workload and their own knowledge and skills, affected their abilities to offer quality care. At the same time, providers were challenged by societal factors such as male partner participation, financial constraints, misconceptions and leadership support. While making changes to the elements of quality care that clients experience is important, it is not sufficient in view of the organisational and social barriers. Across the different levels of the ecological framework, providers face barriers to providing quality family planning services that are synergistic. Solutions to improve quality of care must address also limitations at the organisational and societal levels since efforts to overcome a particular constraint are less likely to be successful if this interdependence is not taken into account.
Perry, Rachel; Lunde, Britt; Chen, Katherine T
We aimed to identify mobile applications (apps) about contraception and to evaluate those targeted toward providers of family planning services in order to assess their quality and comprehensiveness. We systematically searched the Apple iTunes Store using contraception search terms. We created a master list of relevant and unique apps and divided the apps into categories and subcategories according to intended audience and purpose. We then checked availability of contraception apps for providers in the Google Play Store. We scored apps on objective and subjective components using the APPLICATIONS scoring system, a tool developed to evaluate health-related mobile apps with a maximum score of 17 points. From a total of 1218 apps found using 41 contraception search terms, 113 were unique and relevant to contraception. We determined that six apps (5.3%) were potentially useful for providers of family planning services and evaluated them. Four apps received 12 points, one received 11 points and one received 8 points. The two free apps were among those with the highest scores. Three of these apps were also available in the Google Play Store. A small number of contraception apps are targeted toward providers of family planning services. Available apps are variable in quality and comprehensiveness. There is potential for further mobile resource development in the area of contraception, given the limited number and inconsistent quality of available apps. Copyright © 2016 Elsevier Inc. All rights reserved.
Nishtar, Noureen Aleem; Sami, Neelofar; Alim, Sabina; Pradhan, Nousheen; Hasnain, Farid Ul
.... The study was conducted to explore family planning service providers' perceptions regarding use of different contraceptive methods and to identify factors that are influencing their use amongst...
Kelly, Patricia J; Witt, Jacki; McEvers, Kimberly; Enriquez, Maithe; Abshier, Patricia; Vasquez, Magda; McGee, Eve
Natural family planning (NFP) methods are effective for contraception with proper and consistent use. However, only 1% of patients at federally funded Title X family planning clinics select NFP as a contraceptive method. The goal of this study was to understand from clinicians' perspectives the barriers and facilitators to providing NFP methods. Six telephone focus groups were conducted with 29 clinicians from Title X clinics across the United States and Puerto Rico. A hermeneutic method was used to analyze data for related themes. The overarching theme from the study was that participants had a strong desire to teach their patients how their bodies work and to empower them to learn to control fertility. Four subthemes emerged: patient misinformation and misunderstanding about fertility; provider ideas about ideal types of candidates for NFP; inconsistent patient teaching strategies; and lack of time to teach NFP methods. There is a need for increased NFP training for providers and efficient NFP patient teaching strategies to meet the needs of patients with limited knowledge about fertility. © 2011 by the American College of Nurse-Midwives.
Baraka, Jitihada; Rusibamayila, Asinath; Kalolella, Admirabilis; Baynes, Colin
Provider perspectives have been overlooked in efforts to address the challenges of unmet need for family planning (FP). This qualitative study was undertaken in Tanzania, using 22 key informant interviews and 4 focus group discussions. The research documents perceptions of healthcare managers and providers in a rural district on the barriers to meeting latent demand for contraception. Social-ecological theory is used to interpret the findings, illustrating how service capability is determined by the social, structural and organizational environment. Providers' efforts to address unmet need for FP services are constrained by unstable reproductive preferences, low educational attainment, and misconceptions about contraceptive side effects. Societal and organizational factors--such as gender dynamics, economic conditions, religious and cultural norms, and supply chain bottlenecks, respectively--also contribute to an adverse environment for meeting needs for care. Challenges that healthcare providers face interact and produce an effect which hinders efforts to address unmet need. Interventions to address this are not sufficient unless the supply of services is combined with systems strengthening and social engagement strategies in a way that reflects the multi-layered, social institutional problems.
Full Text Available Violeta J Rodriguez,1 Ryan R Cook,1 Stephen M Weiss,1 Karl Peltzer,2–4 Deborah L Jones1 1Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; 2HIV/AIDS/STIs and TB (HAST Research Programme, Human Sciences Research Council, Pretoria, South Africa; 3ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand; 4Department of Psychology, University of Limpopo, Turfloop, South Africa Abstract: Patient–provider family planning discussions and preconception counseling can reduce maternal and neonatal risks by increasing adherence to provider recommendations and antiretroviral medication. However, HIV-infected women may not discuss reproductive intentions with providers due to anticipation of negative reactions and stigma. This study aimed to identify correlates of patient–provider family planning discussions among HIV-infected women in rural South Africa, an area with high rates of antenatal HIV and suboptimal rates of prevention of mother-to-child transmission (PMTCT of HIV. Participants were N=673 pregnant HIV-infected women who completed measures of family planning discussions and knowledge, depression, stigma, intimate partner violence, and male involvement. Participants were, on average, 28 ± 6 years old, and half of them had completed at least 10–11 years of education. Most women were unemployed and had a monthly income of less than ~US$76. Fewer than half of the women reported having family planning discussions with providers. Correlates of patient–provider family planning discussions included younger age, discussions about PMTCT of HIV, male involvement, and decreased stigma (p < 0.05. Depression was indirectly associated with patient–provider family planning discussions through male involvement (b = −0.010, bias-corrected 95% confidence interval [bCI] [−0.019, −0.005]. That is, depression decreased male involvement, and in turn, male involvement
Nishtar, Noureen Aleem; Sami, Neelofar; Alim, Sabina; Pradhan, Nousheen; Hasnain, Farid Ul
In Pakistan, Contraceptive Prevalence Rate (CPR) among married female youth is 17.4% and even lower in rural and slum areas leading to rapid population growth on one hand and poor health consequences on the other. The study was conducted to explore family planning service providers' perceptions regarding use of different contraceptive methods and to identify factors that are influencing their use amongst currently married youth aged 18-24 years in slum areas of Karachi. Qualitative exploratory study design was adopted and a total of ten in-depth interviews were conducted with family planning service providers of the area. For content analysis coding of transcribed interviews was done and then categories were made and furthermore themes were derived. Our findings revealed that family planning service providers perceived that there is low use of contraceptive methods amongst youth of study area and low usage could be due to side effects; myths and misconceptions; lack of proper knowledge about different contraceptives; unmet needs of contraceptives; socio-cultural and religious factors about different contraceptive methods and family planning service providers own biases against or for use of contraceptive methods amongst youth in the study area. However better education of youth and family planning service providers' improved knowledge about counseling and use of contraceptive methods was perceived to be associated with improved use of family planning methods amongst youth of the study area. Exaggerated side effects and socio-cultural factors could be important influences leading to low use of family planning methods amongst youth of Karachi. Some policy initiatives are the training of lady health Workers, lady health visitors, physicians and staff of the pharmacies for counseling youth in the correct use of family planning methods.
Vaaler, Margaret L; Kalanges, Lauri K; Fonseca, Vincent P; Castrucci, Brian C
Despite the elevated rates of teen and unplanned pregnancies across the United States, long-acting reversible contraceptives (LARCs) remain a less utilized birth control method. The present study investigated family planning providers' attitudes and considerations when recommending family planning methods and LARCs to clients. Additionally, this study explored whether urban-rural differences exist in providers' attitudes toward LARCs and in clients' use of LARCs. Data were collected using an online survey of family planning providers at Title X clinics in Texas. Survey data was linked to family planning client data from the Family Planning Annual Report (2008). Findings indicated that, although providers were aware of the advantages of LARCs, clients' LARC use remains infrequent. Providers reported that the benefits of hormone implants include their effectiveness for 3 years and that they are an option for women who cannot take estrogen-based birth control. Providers acknowledged the benefits of several types of LARCs; however, urban providers were more likely to acknowledge the benefits of hormone implants compared with their rural counterparts. Results also indicated barriers to recommending LARCs, such as providers' misinformation about LARCs and their caution in recommending LARCs to adolescents. However, findings also indicated providers lack training in LARC insertion, specifically among those practicing in rural areas. In light of the effectiveness and longevity of LARCs, teenagers and clients living in rural areas are ideal LARC candidates. Increased training among family planning providers, especially for those practicing in rural areas, may increase their recommendations of LARCs to clients. Copyright © 2012 Jacobs Institute of Women
Biggs, M Antonia; Harper, Cynthia C; Brindis, Claire D
To assess the extent to which practices offering family planning services are able to offer intrauterine devices (IUDs) and implants in one visit and to identify the reasons why multiple visits may be required. In the fall of 2011, 1,000 California family planning providers were asked about their long-acting reversible contraception delivery practices in a probability survey. We used multivariable logistic regression to examine practice characteristics associated with same-day provision of IUDs and implants. Among the 636 responding practices, 67% offered an IUD and 40% offered a contraceptive implant onsite. Among those with onsite provision, the majority required two or more visits to place an IUD (58%); almost half required two visits to place an implant (47%). Nearly all Planned Parenthood practices could place an IUD (95%) or implant (95%) at the initial visit, whereas the majority of all other practice types could not. The main reasons for delaying IUD and contraceptive implant provision included the need to screen and wait for test results (68% and 24%, respectively) and clinic flow and scheduling issues (50% and 64%, respectively). Multivariable analyses indicated that Planned Parenthood practices were significantly more likely than private practices to have same-day insertion protocols. Most of the family planning providers surveyed have not adopted same-day long-acting reversible contraception insertion protocols and face barriers to same-day provision. III.
Chow, Joan M; de Bocanegra, Heike Thiel; Hulett, Denis; Park, Hye-Youn; Darney, Philip
Annual chlamydia screening is recommended for adolescent and young adult females and targeted screening is recommended for women ≥26 years based on risk. Although screening levels have increased over time, adherence to these guidelines varies, with high levels of adherence among Title X family planning providers. However, previous studies of provider variation in screening rates have not adjusted for differences in clinic and client population characteristics. Administrative claims from the California Family Planning, Access, Care, and Treatment (Family PACT) program were used to (1) examine clinic and client sociodemographic characteristics by provider group-Title X-funded public sector, non-Title X public sector, and private sector providers, and (2) estimate age-specific screening and differences in rates by provider group during 2009. Among 833 providers, Title X providers were more likely than non-Title X public sector providers and private sector providers to serve a higher client volume, a higher proportion of clients aged ≤25 years, and a higher proportion of African American clients. Non-Title X public providers were more likely to be located in rural areas, compared with Title X grantees and private sector providers. Title X providers had the largest absolute difference in screening rates for young females vs. older females (10.9%). Unadjusted screening rates for young clients were lower among non-Title X public sector providers (54%) compared with private sector and Title X providers (64% each). After controlling for provider group, urban location, client volume, and percent African American, private sector providers had higher screening rates than Title X and non-Title X public providers. Screening rates for females were higher among private providers compared with Title X and non-Title X public providers. However, only Title X providers were more likely to adhere to screening guidelines through high screening rates for young females and low
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.
Nishtar, Noureen Aleem; Sami, Neelofar; Alim, Sabina; Pradhan, Nousheen; Farid-Ul-Hasnain,
Introduction: In Pakistan, Contraceptive Prevalence Rate (CPR) among married female youth is 17.4% and even lower in rural and slum areas leading to rapid population growth on one hand and poor health consequences on the other. The study was conducted to explore family planning service providers? perceptions regarding use of different contraceptive methods and to identify factors that are influencing their use amongst currently married youth aged 18-24 years in slum areas of Karachi. Method: ...
Information dissemination is part of the communication component of successful family planning program operation. Communication informs people about family planning, motivates them to practice it, and teaches them how to correctly use safe and reliable methods. Family planning communication is receiving renewed attention in the late 1980s in nearly all parts of the world. 1 of the most effective ways to reach policymakers and service providers is through newsletters. At the 1986 Family Health Research Centers Directors Conference, 4 of the 6 directors said they regularly publish newsletters. Workshops, conferences, and seminars are other forums for information dissemination. These forums present ideal opportunities for media coverage, 1 of the best ways to spread information about contraceptive research findings and family planning. Advice columns are a way to publicize family planning in print media on a regular basis. It may be necessary for leaders of family planning groups to make the 1st efforts to contact editors and broadcast personnel. While family planning is no longer a new topic in most countries, it remains true that important information needs to circulate and that family planners can help this process by helping the media cover it.
Family planning and its association with women's health and the health of families, communities, and societies will be a central theme of the International Conference on Population and Development in Cairo, Egypt, in September 1994. The conference will provide an opportunity to determine new directions for the development of family planning programs. Making family planning programs woman-friendly is to insure that they: are based on the principle of voluntary informed choice; are available to all; offer confidentiality in counseling and services; provide a broad choice of traditional and modern methods; make the user's safety a prime concern; encourage male involvement; are supportive of women with unwanted pregnancies; and provide protection from, as well as management of, sexually transmitted diseases. The need to encourage male involvement and sharing in responsibilities is essential. Although the bulk of contraceptive methods are for use by women, many require the active cooperation of men. With the spread of sexually transmitted diseases and HIV/AIDS, barrier methods and cooperation between sex partners will gain importance. The responsibilities of men as partners, fathers, and family members should be emphasized in all family planning programs. Policy makers must insure that family planning programs offer high quality counseling, the prevention of unsafe abortion, and the management of genital infections, sexually transmitted diseases, infertility and diseases of the reproductive tract.
Tang, Longmei; Wu, Shangchun; Li, Jiong; Wang, Kun; Xu, Jialin; Temmerman, Marleen; Zhang, Wei-Hong
To assess the practice of post-abortion family planning (PAFP) counselling among Chinese abortion service providers, and identify the influencing factors. A cross-sectional questionnaire survey was conducted between July and September 2013 among abortion services providers in 30 provinces in China. Univariate and multivariable logistic regression analyses were used to identify the factors that influenced PAFP counselling. 94% of the 579 service providers responded to the questionnaire in the survey. The median age was 39 years (range 20-72), and 95% were females. 92% providers showed a positive attitude and had promoted the PAFP counselling services; however, only 57% spent more than 10 min for it. The overall knowledge on PAFP was limited to the participants. After adjusting for potential confounding factors: providers from the middle region (compared with 'east region', ORadj = 3.33, 95% CI: 2.12-5.21) conducted more PAFP counseling; providers with more knowledge (ORadj = 2.08, 95% CI: 1.38-3.15) provided more counseling; and compared with 'middle school and below', providers with higher education gave more counseling [ORadj(95% CI)] for 'college', 'university' and 'master/doctor' [1.99 (1.01,3.92), 2.32 (1.22,4.40) and 2.34 (1.06,5.17), respectively]. The majority of providers could provide PAFP counselling to women undergone an abortion, but some of them had insufficient time to make it available. Education, knowledge about fertility and reproductive health and residence region were the main factors influencing the practice. Training of health providers and integrating family planning as a part of abortion services are essential to provide adequate PAFP to abortion seekers, thereby reducing the risk of unintended pregnancy.
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
Tang, Longmei; Wu, Shangchun; Li, Jiong
/doctor' [1.99 (1.01,3.92), 2.32 (1.22,4.40) and 2.34 (1.06,5.17), respectively]. Conclusions: The majority of providers could provide PAFP counselling to women undergone an abortion, but some of them had insufficient time to make it available. Education, knowledge about fertility and reproductive health...
... Natural Family Planning Share Print Natural family planning (NFP) is a form of pregnancy planning. It does not involve medicine or devices. NFP helps people know when to have sexual intercourse. ...
Full Text Available Starr Hilliard, Sarah A Gutin, Carol Dawson Rose Department of Community Health Systems, School of Nursing, University of California at San Francisco, San Francisco, CA, USA Background: Family planning is an important HIV prevention tool for women living with HIV (WLHIV. In Mozambique, the prevalence of HIV among women of reproductive age is 13.1% and the average fertility rate is high. However, family planning and reproductive health for WLHIV are under-addressed in Mozambique. This study explores provider descriptions of reproductive health messages in order to identify possible barriers and facilitators to successfully addressing family planning and pregnancy concerns of WLHIV. Methods: In 2006, a Positive Health, Dignity, and Prevention program was introduced in Mozambique focused on training health care providers to work with patients to reduce their transmission risks. Providers received training on multiple components, including family planning and prevention of mother-to-child transmission (PMTCT. In-depth interviews were conducted with 31 providers who participated in the training in five rural clinics in three provinces. Data were analyzed using qualitative content analysis. Results: Analysis showed that providers' clinical messages on family planning, pregnancy, and PMTCT for WLHIV could be arranged along a continuum. Provider statements ranged from saying that WLHIV should not become pregnant and condoms are the only valid form of family planning for WLHIV, to suggesting that WLHIV can have safe pregnancies. Conclusion: These data indicate that many providers continue to believe that WLHIV should not have children and this represents a challenge for integrating family planning into the care of WLHIV. Also, not offering WLHIV a full selection of family planning methods severely limits their ability to protect themselves from unintended pregnancies and to fully exercise their reproductive rights. Responding to the reproductive health
natural family planning by the Government. The Ministry of Health in collaboration with government through partnership should plan for training natural family planning teachers as they are the ones who can teach people on family planning in their communities. This will also improve on utilization as some clients cited that ...
Kleinman, Ronald L., Ed.
The International Planned Parenthood Federation (IPPF) believes that all people have the right to family planning information, including premarital and marital counseling, contraception information, and sex education. This physician's handbook is designed to provide all doctors with the necessary instructions on the latest family planning methods…
Blackstock, Oni J.; Mba-Jonas, Adamma; Sacajiu, Galit M.
Disparities in the rates of unintended pregnancy have increased for low-income African American women as compared to other groups due, in part, to declining contraception use. Women obtain family planning information from diverse sources, which may ultimately influence contraceptive decision making. For this qualitative study, we conducted…
Moon, Sherril; Simonsen, Monica L.; Neubert, Debra A.
The purpose of this exploratory study was to survey community rehabilitation providers (CRPs) to determine their perceptions of the skills, experiences, and information that transitioning youth with developmental disabilities (DD) and their families need to access supported employment (SE) services. Supervisors of SE from 12 CRPs across one state…
The high rates of infant, child, and maternal mortality and morbidity observed in many developing countries could be decreased through the provision of adequate family planning services. Poor women in developing countries, compared to women in industrialized nations, have poor health statuses and little or no access to health care. In addition, they endure frequent pregnancies throughout their reproductive life spans. Closely spaced births do not give these women's bodies an opportunity to recuperate from the strains of pregnancy, and these drained women are further burdened with the task of caring for large families. Many women in developing countries subject themseleves to the riskse associated with illegal abortion in order to avoid another unwanted pregnancy. Maternal mortality rates in come countries are as high as 1000/100,000 live births, 2/3 of all pregnant women in developing countries (excluding China) suffer from nutritional anemia, and 200,000 women die each year from illegal abortions. Closely spaced births and childbearing during the late and early phases of the reproductive life span enhance, not only the risk of maternal mortality and morbidity, but the risk of infant and child mortality and morbidity. Children born after a birth interval of 1 year or less are 2 times more likely to die than children born after a birth interval of 2 or more years. Compared to infants born to women aged 20-35 years, infants born to women under 20 years of age have a higher risk of premature birth, and those born to women over 35 years of age have a greater risk of death and of birth defects. The provision of family planning services would also help couples overcome infertility problems and provide women with an opportunity to pursue educational and employment goals. The decline in breastfeeding in developing countries increases the need to provide family planning services. Breastfeeding delays the return of fertility following delivery. As breastfeeding declines
The major sources of funding for family planning associations include: 1) contributions from foundations and private individuals; 2) government subsidies; 3) international assistance; and 4) profits from family planning services, e.g., contraceptive sales, operation of family planning clinics and health check laboratories, and sales of educational materials. In many Asian countries, the operation of health check laboratories appears to be an especially promising source of income. Industrialization and higher education have produced an increased emphasis on good health and a higher quality of life. Family planning associations can thus play a role in providing regular health check-ups and health education for all family members. Family planning counseling can be provided to clients as a part of their medical check-ups. Since such examinations should be conducted on a yearly basis, a fixed amount of income can be assumed. Family planning associations that are considering starting a health examination program should invest in the necessary facilities and equipment, recruit medical doctors and laboratory technicians, and form linkages with specialists, hospitals, universities, and other research institutions. It may take 3-5 years for a family planning association to accumulate the necessary technology and experience in this field and to acquire the confidence of the general public.
Some interviews with educated women about their thoughts on family planning, birth spacing, and desired family size are provided. There were rumors that Nigerian women wanted birth spacing because the economy was so bad. There was a question about whether women desired family planning for both birth spacing and family limitation without jeopardizing conjugal felicity, or whether the government campaigns for smaller family size were being effective, or whether the economic realities were forcing rethinking. The responses came from a legal assistant in her early 30s; a health consultant, a 27-years old baby wear dealer, a 27-year old nurse, a 54-years old academician, a 44-year old librarian, a 35-year old pharmacist, and a fashion designer. Mrs. Ige, the legal assistant, married at 28 years believed that family planning was essential and the desired family size was around 4, but more importantly family size was based on the parents ability to provide "adequate" care. The health consultant with 4 children considered that a mother had a life after children and living standards were not improving. The baby war dealer with 2 children believed that family planning provided the opportunity to plan for the education of your children; the number of educated children depended on the ability of society to provide adequate jobs. The nurse was not married and planned to seek counseling in family planning after her first child. The academician with 4 children believed individuals had the right to decide the desired number of children, but should be guided by the principle of having no more than they could adequately care for. The librarian with 4 children thought family planning was nice for helping ladies plan their families according to their means; wealthy families could afford 4-5 children, and middle income earners could only afford 2-3 children. The fashion designer with 2 children said that family planning was necessary for spacing the number of children and giving the
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...
Pinter, Bojana; Hakim, Marwan; Seidman, Daniel S; Kubba, Ali; Kishen, Meera; Di Carlo, Costantino
Religion is embedded in the culture of all societies. It influences matters of morality, ideology and decision making, which concern every human being at some point in their life. Although the different religions often lack a united view on matters such contraception and abortion, there is sometimes some dogmatic overlap when general religious principles are subject to the influence of local customs. Immigration and population flow add further complexities to societal views on reproductive issues. For example, present day Europe has recently faced a dramatic increase in refugee influx, which raises questions about the health care of immigrants and the effects of cultural and religious differences on reproductive health. Religious beliefs on family planning in, for example, Christianity, Judaism, Islam and Hinduism have grown from different backgrounds and perspectives. Understanding these differences may result in more culturally competent delivery of care by health care providers. This paper presents the teachings of the most widespread religions in Europe with regard to contraception and reproduction.
Brown, J B; Blackwell, L F; Billings, J J; Conway, B; Cox, R I; Garrett, G; Holmes, J; Smith, M A
It is now well accepted that a woman can conceive from an act of intercourse for a maximum of only about 7 days of her menstrual cycle. The reliability of natural family planning depends on identifying this window of fertility without ambiguity. Several symptomatic markers, cervical mucus and basal body temperature, have been used extensively and with considerable success in most women but failures occur. Ovarian and pituitary hormone production show characteristic patterns during the cycle. Urinary estrogen and pregnanediol measurements yield reliable information concerning the beginning, peak, and end of the fertile period, provided that the assays are accurate and performed on timed specimens of urine. We have developed such enzyme immunoassays for urinary estrogen and pregnanediol glucuronides that can be performed at home. In the early versions of the assays, enzyme reaction rates were measured by eye, but more recently, a simple photoelectronic rate meter has been used. The final problem to be solved is not technologic but whether women are sufficiently motivated to expend the same time and effort each day for 10 days a month, with less cost, on fertility awareness as they spend on making a cup of tea.
The US Agency for International Development (USAID) has been a leader in international family planning for almost 30 years, accounting for 46% of all funds in international family planning provided by OECD countries during 1991. Moreover, relative to other donor countries, the US supplies worldwide a disproportionate amount of contraceptives. While international family planning activities received $546 million in 1995, the budget was slashed in 1996 to $72 million. This unprecedented cut will have a profound effect upon the reproductive health and family planning choices of tens of millions of people in developing countries. Millions of additional unintended pregnancies and maternal and child deaths may result. 1996 began with the White House and Congress in political gridlock, with negotiations on foreign aid stalled on the issue of abortion. The Republican-led House of Representatives wanted to bar support of any nongovernmental organization (NGO) which also provided information on abortion, while Democratic President Bill Clinton affirmed that he would veto such legislation. At the end of January, the House passed the Balanced Budget and Down Payment Act (HR 2880) containing clauses which cut the aid budget by 35% and barring new money in the area of family planning until July 1. Spending was limited to the allocation of 6.5% of the total budget each month. Some social marketing programmers who distribute condoms and oral contraceptives are already feeling the pinch, and some programs will simply run out of contraceptives. This cut in funding also bodes ill for achieving the goals of the 1994 International Conference on Population and Development. There is, however, hope that the cuts will be reversed for the next fiscal year. The author notes survey findings which indicate that US citizens support higher budgets for family planning.
The focus is in terms of family planning as an exercise in induced social change; the objective is to alter the reproductive patterns of societies sufficiently to bring about a significant reduction in fertility. The year 1974 emerges as the year in which family planning as a social movement achieved maturity and was confirmed as a legitimate area for national policy and programming, a year of determined and varied efforts to reduce population growth. In affirming the rights and responsibilities of people and the obligations of governments in population concerns, the Bucharest Conference conferred its seal of approval on a movement that had made considerable progress since it began early in the 19th century. The evolution of birth control as a social movement which began with Francis Place's printing and distributing contraceptive bills in 1820 was encouraged by other writings in England and the U.S. over the next 50 years. Several overlapping phases can be distinguished in the global response to a new sense of urgence regarding population concerns following World War 2. Moving from a global perspective to consideration of family planning as it exists in the programs of individual countries, the achievement is not so great and the prospects are less hopeful. Although it has had success as a social movement and is now accepted as a government responsibility, family planning programs still have a long way to go before they develop the scope, vigor, and versatility that is required for there to be widespread demographic change. 1 change that is needed is for a stronger and more visible political commitment and commitment on the basis of demographic rather than health or welfare reasons.
As a result of a study conducted by the Family Planning Association in Guatemala, it was learned that a favorable climate exists for an integrated orientation program which includes family planning. Consequently, the Association developed a 5-year program of health education, family life education, social organization and advancement, training, and family planning. The program's objectives are: 1) to promote the well-being of the rural family, encouraging the exercise of the duty and the right of responsible and conscious procreation; 2) to continue to uphold the family in rural areas as the basis for society; and 3) to contribute to the reduction of health risks, induced abortion, infant mortality, malnutrition, poverty, and ignorance. There are program projects that focus on economic development, health education, family life, social organizations, and other aspects within the socioecnomic realms. Courses on family planning, responsible parenthood, and family life were also offered. Additionally, family planning services are provided on a voluntary basis under the medical supervision of the family orientation unit in the township of Tactic. A study conducted to evaluate the health, social, and economic situation in Tactic revealed: 82 persons stated that family planning was good, 54 individuals claimed to know how to prevent pregnancies, and 51 claimed ignorance of family planning. Additionally, a majority of the people interviewed reported a desire to have small families. Parents have expressed an interest in sex education, and 47 of those interviewed indicated that they would teach their children about birth control.
A public health nurse from London describes the customs of nomadic people in the British Isles, known as "travellers," as they affect provision of family planning services. Most are of British or Irish stock, some migrate and others live in caravan sites all year. Their traditions dictate that men work and women are housewives. Early, often arranged, marriage, early childbearing and large families are the norm. Sex and contraception are not considered appropriate for discussion between the sexes, or in the presence of children. Large families and financial hardship force many women to space pregnancies. Women often have to hide contraceptives from their husbands, difficult in conditions without privacy. Therefore they prefer IUDs, but some use oral contraceptives, although sometimes erratically because most are illiterate. Traveller women are usually unwilling to do self-examination, as needed with IUDs. They often have difficulty attending regular Pap smear clinics. Cervical cancer rates are high. They experience discrimination in clinics, and need extra care about modesty. It is worth while to take time to develop trust in the clinical relationship, to deal with the traveller woman's uneasy among outsiders.
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…
Hardy, James M.
A document intended to provide program planning guidelines for Young Men's Christian Associations (YMCAs) desirous of working with families, recommends adherence to eight principles and following of five steps. The principles involve planning before action, fact finding and analysis, clear delineation of operational objectives, planning at all…
... 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 planning services, the plan must provide that each recipient is free from coercion or mental pressure and...
Plank, S J
Family allowances designed to promote maternal and child health and welfare could be self-defeating if they stimulated otherwise unwanted births, as often assumed. That assumption, with its public health and demographic implications, needs testing. An attempt to test it was made in Chile in 1969--1970 through interviews with 945 wives receiving an allowance and 690 non-recipients. Recipients practiced contraception significantly more than did non-recipients. This was not explained by wives' educational attainment or employment, the couples' earnings, or number of living children, but was associated with a 50 per cent greater utilization of professional prenatal care by recipients during the most recent pregnancy; women with such care (regardless of allowance status) were 75 per cent more likely than others to control their fertility. Prenatal care was probably sought more by recipients in part because an additional stipend was provided as soon as pregnancy was confirmed, usually at clinics with integrated family planning. Greater family income, attributable to the allowance, probably also contributed to the recipients' better prenatal attention and to contraceptive practice. Noteworthy, too, was the finding that with the number of living children controlled, contraceptive practice was significantly greater amoung couples who had never lost a child.
Charandabi, Sakineh Mohammad-Alizadeh; Vahidi, Rezagoli; Marions, Lena; Wahlström, Rolf
Peer education is an interactive method of teaching or learning which is widely used for educating school and college students, in a variety of different forms. However, there are few studies on its effectiveness for in-service education. The aim of this study was to evaluate the effect of an educational programme including peer discussions, based on a needs assessment, on the providers' knowledge and reported performance in family planning services. An educational programme was designed and applied in a random selection of half of in-charges of the 74 family health units (intervention group) in Tabriz at a regular monthly meeting. The other half constituted the control group. The programme included eight pages of written material and a two-hour, face-to-face discussion session with emphasis on the weak areas identified through a needs assessment questionnaire. The educated in-charges were requested to carry out a similar kind of programme with all peers at their health facilities within one month. All in-charges received one self-administered questionnaire containing knowledge questions one month after the in-charge education (follow-up I: 61 responses), and another one containing knowledge and self-reported performance questions 26 months later (follow-up II: 61 responses). Also, such tests were done for the peers facilitated by the in-charges one (105 responses) and 27 months (114 responses) after the peer discussions. Multiple linear regression was used for comparing mean total scores, and Chi square for comparing proportions between control and intervention groups, after defining facility as the unit of randomization. The mean total percentage scores of knowledge (percent of maximal possible score) in the intervention group were significantly higher than in the control group, both at follow-up I (63%) and at follow-up II (57%); with a difference of 16 (95% CI: 11, 22) and 5 (95% CI: 0.4, 11) percentage units, respectively. Only two of the nine reported
Abraham De D'ornellas, R
The treatment in the press of family planning hinges on two fundamental factors: the taboo of the leftist groups and the taboo of the Catholic Church, whose head is against abortion under any circumstances. Leftist views insinuate that family planning is the genocidal plan of North American imperialists against the Third World and, in particular, against Latin America. This genocidal plan is supposed to subject poor populations to international schemes. In the press family planning is often treated in a sanctimonious fashion, lumping it together with topics like pornography, sex, and violence. In 1983 the daily newspaper Expreso published a supplement running every week for almost three months about the issue of population, which dealt fairly extensively with such topics as population and housing, education, employment, and urban proliferation, as well as responsible parenthood and child survival. In addition, there was a detailed description of contraceptive methods. In October 1986 another surprising thing happened: the President of Peru talked about the topic of family planning, which at the time was an act of courage. Since then much has changed; the whole world is interested in family planning and certain aspects of population. Since October 1986 more has been published in this domain than during the preceding 20 years. In contrast, the Church reacted differently to this issue: after some initial caution, the conference of Peruvian bishops attacked all methods of modern contraceptives and private institutions of family planning. The information boom in family planning will certainly continue. At the moment this flood of articles and editorials about the issue is an expression of the anxiety of families related to uncontrolled reproduction and the fear of overpopulation in large cities devoid of minimal services.
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
Dr. Jean Infield, a family planning expert from England, was invited to conduct a series of refresher lectures to the medical personnel of the Association. The 4-session refresher course was held in the mornings of February 26 to March 1 for 47 doctors, advisers and nurses. The topics were on the choice of contraceptive, postcoital contraception, overview of hormonal contraception, myths and fallacies of oral contraceptives, intrauterine contraception, contraception for the older women and barrier methods. Participants agreed that the lectures were informative and useful to their work in family planning. full text
The switch in emphasis in population policies from family planning to the development of socioeconomic policies that would encourage smaller families--summed up in the word "developmentalism"--is charted from a 1967 paper by Kinsley Davis to its culmination at the 1974 World Population Conference, when even as staunch a supporter of family planning as John D. Rockefeller came out in support of placing population policy in the context of economic and social development. The real question is, however: To what extent does developmentalism represent a true shift in policy and how much is simply a more sophisticated rhetoric designed to deflect the growing opposition to population control? On the one hand, the endorsement by a man of Rockefeller's stature indicates a significant change. On the other, the changes which the implementation of developmentalism would entail seem irreconcilable with the present political and economic structures of underdeveloped nations and of relations between them and the more developed countries. Further, developmentalism is neither as progressive as its advocates suggest, nor as threatening as its opponents cry. It is, in fact, a prescription for enhancing the effectiveness of family planning through a form of social engineering from the top; its details--more aid, investment, and trade--would involve an expanded Western role in the Third World. It is even suggested that developmentalism might be a cover for the creation of a more stratified society, where marginal members are restricted to their own quarters in an effort to secure political stability and economic growth. In the end, developmentalism might be shortlived, as pressure to step up birth control programs is felt from many quarters.
Schuler, S R; McIntosh, E N; Goldstein, M C; Pande, B R
To investigate why family planning (FP) services in the Kathmandu Valley of Nepal are underused, a study was initiated under the auspices of the Nepal Family Planning/Maternal--Child Health Project. The study was intended to provide a user perspective, by examining interactions between FP clinic staff and their clientele. "Simulated" clients were sent to 16 FP clinics in Kathmandu to request information and advice. The study revealed that in the impersonal setting of a family planning clinic, clients and staff fall into traditional, hierarchical modes of interaction. In the process, the client's "modern" goal of limiting her family size is subverted by the service system that was created to support this goal. Particularly when status differences are greatest, that is, with lower-class and low caste clients, transmission of information is inhibited.
1965 the Rhodesia Family Planning Association (FPA) was formed and 1966 contraceptives were distributed ... function is to educate, motivate and screen clients for oral contraceptives. The distributors role is to ... The Zimbabwe Reproductive Health Survey in 1984 showed that 2 out of 3 ever-in-union women had ever ...
Ayub, Emily M; Sampayo, Esther M; Shah, Manish I; Doughty, Cara B
A gap exists in understanding a provider's approach to delivering care that is mutually beneficial to patients, families, and other providers in the prehospital setting. The purpose of this study was to identify attitudes, beliefs, and perceived barriers to providing patient and family centered care (PFCC) in the prehospital setting and to describe potential solutions for improving PFCC during critical pediatric events. We conducted a qualitative, cross-sectional study of a purposive sample of Emergency Medical Technicians (EMTs) and paramedics from an urban, municipal, fire-based EMS system, who participated in the Pediatric Simulation Training for Emergency Prehospital Providers (PediSTEPPS) course. Two coders reviewed transcriptions of audio recordings from participants' first simulation scenario debriefings and performed constant comparison analysis to identify unifying themes. Themes were verified through member checking with two focus groups of prehospital providers. A total of 122 EMTs and paramedics participated in 16 audiotaped debriefing sessions and two focus groups. Four overarching themes emerged regarding the experience of PFCC by prehospital providers: (1) Perceived barriers included the prehospital environment, limited manpower, multi-tasking medical care, and concern for interference with patient care; (2) Providing emotional support comprised of empathetically comforting caregivers, maintaining a calm demeanor, and empowering families to feel involved; (3) Effective communication strategies consisted of designating a family point person, narration of actions, preempting the next steps, speaking in lay terms, summarizing during downtime, and conveying a positive first impression; (4) Tactics to overcome PFCC barriers were maintaining a line of sight, removing and returning a caregiver to and from the scene, and providing situational awareness. Based on debriefings from simulated scenarios, some prehospital providers identified the provision of
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
Thornburg, Kathy R; Crompton, Dwayne; Townley, Kimberly
Examined the relationship between competence and burnout in 226 family child care providers. Identified the combination of variables that contribute to competence and burnout in caregivers, including age and educational level, use of lesson plans, perceived adequacy of space, and satisfaction with equipment and materials. Findings posed…
Suneela Garg; Ritesh Singh
The family planning programme of India has shown many significant changes since its inception five decades back. The programme has made the contraceptives easily accessible and affordable to the people. Devices with very low failure rate are provided free of cost to those who need it. Despite these significant improvements in service delivery related to family planning the programme cannot be said to achieve success at all levels. There are many issues with the family planning services availa...
Pursuant to Article R V 1.38 of the Staff Regulations, members of the personnel are reminded that they are required to inform the Organization in writing, within 30 calendar days, of any change in their family situation (marriage, partnership, birth of a child, etc.) and of the amount of any financial benefit of a similar nature to those provided for in the Staff Regulations (e.g. family allowance, child allowance, infant allowance, non-resident allowance or international indemnity) to which they or a member of their family may be entitled from a source other than CERN. The procedures to be followed are available in the Admin e-guide: https://admin-eguide.web.cern.ch/en/procedure/change-family-situation Members of the personnel are also reminded that any false declaration or failure to make a declaration with a view to deceiving others or achieving a gain resulting in a loss of funds or reputation for CERN constitutes fraud and may lead to disciplinary action in accordance with Article S ...
Sirey, A R
In some isolated family planning services innovative uses of new professional manpower are being demonstrated. With specialized training, the paramedical personnel are performing full gynecological screening examinations under the supervision of physicians, serving as clinic administrators, and providing counseling and educative services. Currently not enough funds are being allocated to manpower development. In 1973 only 3% of federal funds for family planning services were earmarked for this endeavor. There also is an unwillingness of a large percentage of medical and health professionals to accept the potential roles of the new professionals as well as to come to grips with the concept of "consumer participation". This consumer involvement is necessary in developing a system that is responsive to the patient's needs. Training periods vary for the new professionals from a few weeks to 3 years to prepare Physicians' Assistants. In a 20 week course individuals have been trained to recognize and differentiate normal and abnormal breast and pelvic findings and to provide family planning and cancer screening services including full pelvic exams and insertion of the IUD. Over 100 new professionals who function as in-hospital family planning counselors and community education technicians in a New York City program were trained through the laboratory method approach. The key to the performance of the new professionals in the clinic is proper supervision and good communication between them and the traditionally trained professionals. Some of the dead-end restrictions which characterize so many of the new positions can be removed if efforts are made within each program to provide in-service training or released time for employees to attend seminars, workshops, of courses at suitable institutions to foster growth and mobility.
This review of natural family planning (NFP) focuses on the following: components of the fertile phase; sympto-thermal methods; the history and methodology of NFP (calendar rhythm, basal body temperature, cervical mucus--the Billings Ovulation method); special circumstances--periods of erratic ovulation (puberty, lactation, premenopause, discontinuation of ovulation suppression, cervicitis and vaginitis, ovulation suppression by stress and pharmaceuticals); effectiveness of natural family planning; achieving pregnancy; achieving couple autonomy (confidence in the method, periodic abstinence, dynamics of the learning process, and support systems); problem areas; and delivery systems. The number of users of NFP methods increased from 2.8% of currently married couples in 1973 to 3.4% in 1976. In 1979, 75,000 new clients received training in contemporary NFP, while the number increased to over 100,000 in 1980. NFP is planning for achieving or preventing a pregnancy by the timing of intercourse. A couple can, by observing and recording certain natural symptoms and bodily changes that occur in a woman's menstrual cycle and using the information as a guide, learn to identify fertile and infertile phases in the menstrual cycle. Precise prediction of ovulation forms one of the components of delineation of the fertile phase. Billings pioneered the use of cervical mucus as a single parameter for the prediction of ovulation and its application to NFP. Women are instructed to observe their mucus patterns at the vulva, relying primarily on the sensation of wetness and lubrication, the use of the Kegel exercise, palpation with the finger, a "wipe-through" with toilet paper, or a combination of these observations. In the absence of ovulation, the usual changing mucus pattern is also absent. NFP can be used either to achieve or to avoid pregnancy. When NFP is used to avoid pregnancy, one will encounter method-related pregnancies, teaching-related pregnancies due either to poor
Los Angeles Regional Family Planning Council, CA.
This guidebook is designed to assist health workers in the delivery of information and education regarding reproductive health and fertility control to family planning clients. Aspects of services that might be provided by various staff members are suggested. Initially, family planning philosophy from which general operating principles are derived…
AJRH Managing Editor
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 ...
A diversified pattern of family planning service delivery currently exists, one that is considerably extended through the development of a wide range of supply and distribution channels. In most areas, nongovernmental organizations have played a crucial role in the development of innovative approaches to making contraceptives widely available. In many nations the provision of contraceptives through the national health system continues to be the backbone of the family planning program. Changes in the approach to health care have helped increase the acccessibility and acceptability of family planning services. 2 factors necessitate a close link between contraceptive and health services: the need for medical skills and facilities in the provision of surgical contraceptive methods, and the importance of medical supervision in the continuing use of other methods. A widely used approach integrates contraceptive delivery with other development programs, community-based distribution (CBD) of contraceptives, and commercial retail sales. The cornerstone of CBD is extensive use of community networks and of trained community residents. An effective project requires efficient resupply and distribution mechanisms, carefully designed supervision systems, and medical back-up facilities. CBD has spread to over 40 countries, most of them in Asia and Latin America. Wider use of existing commercial retail outlets is being followed in more than 30 countries. Self-sufficiency of these projects has not been realized, and considerable subsidization continues to be required to maintain their efficiency. Efforts to increase the availability of contraceptives have been facilitated by the widening range of service providers. Nurses, midwives, traditional birth attendants, and members of the community are being trained to perform many family planning tasks in clinical and nonclinical settings. Many of these advances have been made possible by the liberalization of laws and regulations
Family planning programmes initiated in the Islamic Republic of Iran from 1966 met with limited success. Following the 1986 census family planning was considered a priority and was supported by the country's leaders. Appropriate strategies based on the principles of health promotion led to an increase in the contraceptive prevalence rate among married women from 49.0% in 1989 to 73.8% in 2006. This paper reviews the family planning programmes in the Islamic Republic of Iran and their achievements during the last 4 decades and discusses the principles of health promotion and theories of behaviour change which may explain these achievements. Successful strategies included: creation of a supportive environment, reorientation of family planning services, expanding of coverage of family planning services, training skilled personnel, providing free contraceptives as well as vasectomy and tubectomy services, involvement of volunteers and nongovernmental organizations and promotion of male participation.
A family planning association was established in each village of Xiaqidu Township in Hunan Province, China in October 1986. The positive functions of each such association were so fully developed that family planning work reached new levels. For example, most villages are no longer experiencing early marriages or unplanned births. Some of the villages have established associations for individual work groups. The traditional method was for both township and village associations to rely upon the positive attitudes of officials to instill into fertile women Party policy, and to arouse their patriotism and initiative. By establishing family planning associations at the village level, however, the people can conduct their own affairs and educate themselves. Emphasis has been placed on attracting into the associations those who are of childbearing age, as well as older villagers of experience. The associations' raison d'etre was to serve the people. They did so through: propaganda (disseminating population theory, birth control and family planning information); helping the people overcome poverty, traditional thinking, and ignorance; assisting women with any problems and anxieties relating to child-bearing; delivering contraceptives to households; and providing the elderly with care and the young with education.
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.
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.
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.
Jørgensen, Kaj Asbjørn; Petersen, Thomas Ditlev; Nielsen, Kjeld
dependent on the specific assembly structure of the configured product, i.e. the combination of modules. In this paper, issues of how to create manufacturing structures and related planning data in product family models are presented. Primarily, the more complicated multi-level manufacturing structures......To enable product configuration of a product family, it is important to develop a model of the selected product family. From such a model, an often performed practice is to make a product configurator from which customers can specify individual products from the family. To get further utilisation...... of the product family model, however, the model should be enriched with data for planning and execution of the manufacturing processes. The idea is that, when any individual product is specified using the product configurator, a product model can be extracted with all data necessary for planning...
Pursuant to Article R V 1.38 of the Staff Regulations, members of the personnel are reminded that they are required to inform the Organization in writing, within 30 calendar days, of any change in their family situation (marriage, partnership, birth of a child, etc.) and of the amount of any financial benefit of a similar nature to those stipulated in the Staff Regulations (e.g. family allowance, child allowance, infant allowance, non-resident allowance or international indemnity) to which they or a member of their family may be entitled from a source other than CERN. The procedures to be followed are available in the admin e-guide: https://admin-eguide.web.cern.ch/en/procedure/change-family-situation Members of the personnel are also reminded that any false declaration or failure to make a declaration with a view to deceiving others or achieving a gain resulting in a loss of funds or reputation for CERN constitutes fraud and may lead to disciplinary action in accordance with Article S VI 2.01 of ...
Pursuant to Article R V 1.38 of the Staff Regulations, members of the personnel are reminded that they are required to inform the Organization in writing, within 30 calendar days, of any change in their family situation (marriage, partnership, birth of a child, etc.) and of the amount of any financial benefit of a similar nature to those stipulated in the Staff Regulations (e.g. family allowance, child allowance, infant allowance, non-resident allowance or international indemnity) to which they or a member of their family may be entitled from a source other than CERN. The procedures to be followed are available in the Admin e-guide: https://admin-eguide.web.cern.ch/en/procedure/change-family-situation Members of the personnel are also reminded that any false declaration or failure to make a declaration with a view to deceiving others or achieving a gain resulting in a loss of funds or reputation for CERN constitutes fraud and may lead to disciplinary action in accordance with Article S VI 2.01 of ...
Brittain, Anna W.; Williams, Jessica R.; Zapata, Lauren B.; Moskosky, Susan B.; Weik, Tasmeen S.
Context Family planning services are essential for reducing high rates of unintended pregnancies among young people, yet a perception that providers will not preserve confidentiality may deter youth from accessing these services. This systematic review, conducted in 2011, summarizes the evidence on the effect of assuring confidentiality in family planning services to young people on reproductive health outcomes. The review was used to inform national recommendations on providing quality family planning services. Evidence acquisition Multiple databases were searched to identify articles addressing confidentiality in family planning services to youth aged 10–24 years. Included studies were published from January 1985 through February 2011. Studies conducted outside the U.S., Canada, Europe, Australia, or New Zealand, and those that focused exclusively on HIV or sexually transmitted diseases, were excluded. Evidence synthesis The search strategy identified 19,332 articles, nine of which met the inclusion criteria. Four studies examined outcomes. Examined outcomes included use of clinical services and intention to use services. Of the four outcome studies, three found a positive association between assurance of confidentiality and at least one outcome of interest. Five studies provided information on youth perspectives and underscored the idea that young people greatly value confidentiality when receiving family planning services. Conclusions This review demonstrates that there is limited research examining whether confidentiality in family planning services to young people affects reproductive health outcomes. A robust research agenda is needed, given the importance young people place on confidentiality. PMID:26190851
Slater, Penelope J; Fielden, Philippa E; Bradford, Natalie K
The Oncology Family App supports families across the vast state of Queensland, Australia, with easy access to vital information, including management plans for a deteriorating child, patient specific information and other resources. This article describes the development and evaluation of this mobile app. The app was developed and tested in collaboration with parents, caregivers, and clinicians and released in November 2015. This first version featured "Statewide Hospital Contacts," including phone numbers, links to Google maps, and 24-hour emergency contacts with click to call functionality; "When to Call" describing symptoms to look out for in a deteriorating child; "Blood Results Table"; and "Information" listing recommended websites, health care team contacts, appointments, and notes. The app was evaluated through interviews with parents, caregivers and patients and download metrics. Six months after the app release, 68% of the 38 parents and caregivers surveyed had downloaded the app. The most used modules were "Blood Results Table," "When to Call," and "Statewide Hospital Contacts," but families reported using all features available. Families were enthusiastic about the support the app provided and gave useful feedback to direct future development. Using mobile health technology to support families is a novel, but rapidly growing concept. Family and caregiver feedback showed that the Oncology Family App was an efficient and convenient way to provide much needed information. A new version of the app is under development and evaluation of outcomes will be ongoing.
On the basis of Marx and Engels' prediction and thesis of scientific socialism, socialist China, the most populous nation in the world, is the 1st to have realized the planned management of population reproductive in the history of mankind, thus giving an answer to the problem in practice. This paper makes a tentative exploration of such a necessity in socialist family planning. Engels points out that 1) under private ownership, population reproduction takes class antagonism as the basis, while public ownership of the means of production eradicates it; 2) in capitalist society, the reproduction of the labor force is commodity reproduction--public ownership of the means of production can be divorced from the domain of commodity; and 3) under private ownership, population reproduction is purely the private business of an individual or a family whose economic benefit forms the motive force of population reproduction--public ownership liberates it from one's personal gains making it a public affair. The great significance of family planning to economic development can be recognized as production, consumption, and accumulation. Taking family planning as the basis for the reproduction plan of the labor force is the guarantee of realizing the material production plan. Family planning reflects the trend of the structure and change of consumer requirements and provides the direct and indirect objectives of various items of material production planning; it provides the objective basis for social accumulation and the arrangement of expanding reproduction. 3 conclusions are derived: 1) the building up of the public ownership of the means of production affords man the possibility to regulate the production of matter as well as man, 2) the characteristics of the planned development of a socialist national economy demands the planned production of man, and 3) family planning and the development of a socialist economy demand their mutual congruence.
Hardee, Karen; Kumar, Jan; Newman, Karen; Bakamjian, Lynn; Harris, Shannon; Rodríguez, Mariela; Brown, Win
At the 2012 Family Planning Summit in London, world leaders committed to providing effective family planning information and services to 120 million additional women and girls by the year 2020. Amid positive response, some expressed concern that the numeric goal could signal a retreat from the human rights-centered approach that underpinned the 1994 International Conference on Population and Development. Achieving the FP2020 goal will take concerted and coordinated efforts among diverse stakeholders and a new programmatic approach supported by the public health and human rights communities. This article presents a new conceptual framework designed to serve as a path toward fulfilling the FP2020 goal. This new unifying framework, which incorporates human rights laws and principles within family-planning-program and quality-of-care frameworks, brings what have been parallel lines of thought together in one construct to make human rights issues related to family planning practical. © 2014 The Population Council, Inc.
3 social aspects of family planning are discussed: cultural heritage, relations between pathology and parity and the problem of unwanted children. The family as an institution enabled mankind to face successfully the adverse conditions to which it was subjected for thousand of years. Now the role of the family is changing, but this raises the problem of whether to accept a new way of life or follow traditions. No uniform solution is applicable to all places or to all s ocial strata within each country. It is necessary to limit the number of unwanted children that cannot be properly raised, but most women can only resort to abortion, which is unlawful and dangerous. Education in family planning must begin in primary school and promoted among parents. It is necessary to explain that the tradition of early marriage must be stopped, and parents must wait until they are able to p lan their family responsibly and to support and educate their children.
Worldwide, there are an estimated 18 million refugees, people who have crossed international borders to escape political conflict, famine, destruction of their natural environment, or other disasters. There are an additional 24 million displaced individuals, people who left their homes but remain in their own countries. Women and children comprise more than 80% of both groups. Following some major event or series of events, these individuals have typically relocated in large number over a short period of time to an area devoid of the necessary basic facilities to support their rapid influx. International agencies, foreign governments, and nongovernmental organizations usually come forward to provide emergency relief as best they are able. With regard to the delivery of health care, health services for refugees are typically designed to meet emergency needs, such as the provision of clean water, the delivery of adequate food supplies, and the treatment of disease. Family planning is generally not provided, especially to refugees in the early stages of relocation. Reproductive health services during this initial phase are instead usually limited to care for pregnant women. Refugees, however, do have sex. In fact, birth rates in refugee camps are typically higher than they are for the host-country population. Refugees and displaced persons have often undergone some degree of psychological trauma and emotional loss. Families are displaced and separated, and loved ones have died. Those fortunate enough to make it to refugee camps and be restored to a reasonable state of health typically find themselves in limbo, away from their cherished homes, and often mourning the loss of friends, spouses, and/or children. These individuals are going to have sexual intercourse for a number of reasons. Sex relieves the boredom of camp life, especially for young people, some people want to replace children who have died or been separated from the family, women with few or no relatives
Slocker De Arce, C
The motivations which led to creation of a family planning specialty within social medicine are discussed and currently available contraceptive methods are reviewed. Among considerations which lead to family planning are the universal worry about uncontrolled population growth and limited resources, especially in the 3rd World: the earth's population is expected to reach 6.5 billion in the year 2000, but already 2.2 billion persons lack adequate resources. Health education and family planning are needed to promote safe conditions for pregnancy and to avoid pregnancy in cases of genetic deficiency. Family planning is a purely medical problem when the woman has a medical problem that would be life threatening to her or her child in case of pregnancy. Illnesses that may be aggravated by pregnancy include cardiopathy, diabetes, nephropathies, thyroid disease, and tuberculosis. Family planning involves provision of information and counseling for patients suffering such disorders as well as for patients who are infertile. Among psychosocial indications for family planning are 2 major problems of modern society: the quality of life and abortion. Family planning has given women the possibility of becoming sexual companions, but the fact that they and not men must submit themselves to contraceptive methods is a negative psychological factor for the stability of the couple. A great change has occurred in Spanish society, in that marriage used to be the only legitimate context for sexual activity and, for Catholics, the only legitimate sexual activity was that oriented toward procreation. Promiscuity, pornography, and sexual liberties and abuses promote undesired pregnancies and abortions. In addition, premarital and extramarital sexual relations have become more frequent. Some 300,000 abortions occur annually in Spain, but abortion can never be a valued family planning method because of its associated morbidity and mortality, and high costs of hospitalization in cases of
The 1994 Human Development Report from the United Nations Development Program (UNDP) proposes a 20-20 Human Development Compact based on shared responsibilities between poor and rich nations, whereby poor and rich nations would help unmet basic human development needs such as primary education, primary health care, safe drinking water, and family planning over the next 10 years. This would require an additional US $30 to US $40 billion annually. Developing countries would commit 20% of their budgets to human priority concerns instead of the current 10% by reducing military expenditure, selling off unprofitable public enterprises and abandoning wasteful prestige projects. Donor countries would increase foreign aid from the current average of 7% to 20%. The report will propose a new concept of human security at the World Summit for Social Development to be held in March 1995, calling widespread human insecurity a universal problem. On average, poor nations have 19 soldiers for every one doctor. Global military spending has been declining since 1987 at the rate of 3.6% a year, resulting in a cumulative peace dividend of US $935 billion from 1987 to 1994. But this money has not been expended on unmet human needs. India ordered fighter planes at a cost that could have provided basic education to the 15 million Indian girls now out of school. Nigeria bought tanks from the UK at a cost that could have immunized all 2 million unimmunized children while also providing family planning to nearly 17 million couples. UNDP proposes a phasing out of all military assistance, military bases, and subsidies to arms exporters over a 3-year period. It also recommends the major restructuring of existing aid funds, and proposes a serious study on new institutions for global governance in the next century.
There are signs in Nigeria that the family planning message is making powerful headway in the markets and the streets. In 1981 the majority of Nigeria's traditional leaders were wary of family planning, and the media largely ignored the topic. By 1984 Nigerian newspapers had highlighted the country's unchecked population growth, and in 1986 most Nigeria's 19 states have family planning programs. The Futures Group of Washington's 1985 report assessed the effects of population growth on Nigeria's social and economic development. This report, part of the Resources for the Awareness of Population Impact on Development series, projected the impact of restrained and unrestrained population growth on such areas as food production, fuel wood resources, petroleum, education, health, urban growth, and housing. The report drew criticism for being overly pessimistic, yet it had a positve effect on the spread of family planning activities. UN estimates project that at the present growth rate of 3.2% a year, Nigeria's population will double in 22 years to 186 million. A recently developed program of family planning initiatives already is in place in several states with technical assistance and funding from the Population Communication Services of John Hopkins University. Pictorial booklets on oral contraceptives (OCs), IUDs, and condoms now are available in Nigeria's 4 major languages. Demand for these booklets among Ministry of Health clinic personnel already has exceeded the limited supplies. While the Nigerian media have highlighted unchecked population growth since 1984 news papers have been more generous in their coverage than radio and television.
For Muslims the Koran provides the infallible rules of conduct fundamental to their way of life. In the past, conservative religious leaders represented a force opposing changes in the traditional status of women and large family norms in Egypt. However, the Grand Mufti has openly expressed his support for responsible parenthood and family planning. The total fertility rate would not have dropped to 3.9 in Egypt without his strong support for family planning. The Grand Mufti expressed his views on family planning in an interview. Family planning is compatible with the teaching of the Koran. There is no problem in promoting family planning according to the Koran. Family planning is the independent and voluntary decision and right of each couple. The Grand Mufti encourages practice family planning through TV, radio, and newspapers. Among Islamic countries, Egypt is one of the few countries where family planning has been well accepted. Religious leaders, medical doctors, and mass media people recognize that the Koran's teachings harmonize with family planning, therefore the promotion of family planning has been successful. More and more people in other Islamic countries will come to practice family planning as they comprehend the Koran's teachings accurately. However, it will take some time before people in these countries will be able to benefit from family planning, since many countries face economic problems thwarting the development of family planning services. The fact that most of the family planning users are women is immaterial, as family planning is the joint responsibility of the married couple. Men should definitely participate in family planning. Men's participation in family planning fits in with the Koran. At the International Conference on Population and Development to be held in the September, 1994, the Grand Mufti is going to speak on men's responsibility for family planning.
Hamburg, M V
In China, raising the age at marriage is an integral part of the family planning program. The new marriage law sets the minimum age at 22 for men and 20 for women. Marriage is a universal practice, and an unmarried person over 28 is a rarity. For economic purposes, the Central Committee of the People's Republic adopted the 1-child family policy in 1980. Childlessness is not encouraged. An extensive organizational network at the national, provincial, and local governmental levels conducts the family planning program. The media is widely used to publicize the message. Billboards, posters, state-run television, and other media tools regularly promote the virtues of the 1-child family, regardless of the sex of the child. Premarital sex is rare, and sex education, if any, is limited to adults--those about to be married. In Shanghai, physiology education in the middle school does include sex education and reproduction. All hospitals have family planning offices, and services include excellent maternal/child health care and family planning counseling. Family planning services are also found in the workplace. Permission must be obtained from the Production Brigade to marry and to have a child. Inspite of this, the family planning program is not viewed as coercive. When certain segments of the working population want to have more children than have been allocated, adjustments (e.g., delays in marriage or in pregnancy) are made. A unique feature of the program is its use of reward and punishment which varies from province to province, and between rural and urban populations. Economic incentives (monetary subsidies, free education for the children, housing priorities, and pension benefits) are given to those who have 1 child and withheld from those who have 2 children. In some areas, additional economic penalties (payment to state) are required from families with 2 children. Another unique feature is the trend toward later marriage, with 25 or 26 becoming the norm. It appears
El-ansary, A I; Kramer Oe, J
The authors explore social marketing applications in the Louisiana model of statewide program for family planning. The marketing concept has 4 major elements: 1) consumer orientation; 2) social process; 3) integrated effort; 4) profitable operation. Success of program and continued growth are the results of defining services needed by consumer; determining market target; taking services to customer; and emphasizing concept of selling family planning rather than giving free birth control method. Another important facet is the recognition of many participants--community agencies, the church, the American Medical Association, funding sources, and hospitals. This project used anyaltical marketing tools and defined services as human services rather than the narrow family planning services. It also extended activities to multinational environment and adapted the product offering to meet these needs.
Garg, Suneela; Singh, Ritesh
The family planning programme of India has shown many significant changes since its inception five decades back. The programme has made the contraceptives easily accessible and affordable to the people. Devices with very low failure rate are provided free of cost to those who need it. Despite these significant improvements in service delivery related to family planning the programme cannot be said to achieve success at all levels. There are many issues with the family planning services available through the public health facilities in India. Failure to adopt the latest technology is one of these. But the most serious drawback of the programme is that it has never been able to bridge the gap between the two genders related to contraceptives. The programme gave emphasis to women-centric contraceptive and thus women were seen as their clients. The choice to adopt a contraceptive though is 'cafeteria approach' in family planning lexicon; it is the choice of the husband that is ultimately practiced. There is not enough dialogue between husband and wife and husband and health worker to discuss the use of one contraceptive over another. The male gender needs to be taken in confidence while promoting the family planning practice. The integration of gender equity is to be done carefully so as not to make dominant gender more powerful. Only when there is equity between genders while using family planning services the programme will achieve success.
Full Text Available The family planning programme of India has shown many significant changes since its inception five decades back. The programme has made the contraceptives easily accessible and affordable to the people. Devices with very low failure rate are provided free of cost to those who need it. Despite these significant improvements in service delivery related to family planning the programme cannot be said to achieve success at all levels. There are many issues with the family planning services available through the public health facilities in India. Failure to adopt the latest technology is one of these. But the most serious drawback of the programme is that it has never been able to bridge the gap between the two genders related to contraceptives. The programme gave emphasis to women-centric contraceptive and thus women were seen as their clients. The choice to adopt a contraceptive though is ′cafeteria approach′ in family planning lexicon; it is the choice of the husband that is ultimately practiced. There is not enough dialogue between husband and wife and husband and health worker to discuss the use of one contraceptive over another. The male gender needs to be taken in confidence while promoting the family planning practice. The integration of gender equity is to be done carefully so as not to make dominant gender more powerful. Only when there is equity between genders while using family planning services the programme will achieve success.
Okour, Abdulhakeem M; Saadeh, Rami A; Zaqoul, Mona
Counselling plays a key role in enhancing reproductive services, providing contraception-related information and supporting long-term family planning for women of childbearing age. This study aimed to evaluate family planning counselling sessions in selected governmental and private clinics in northern Jordan. This cross-sectional study was conducted between January and June 2016 in Irbid, Jordan. A total of 200 women attending two private clinics affiliated with the Jordanian Association for Family Planning and Protection (JAFPP) and six governmental clinics were invited to participate in the study. Counselling sessions were attended by an independent observer and evaluated with regards to their compliance with the standard Greet, Ask, Tell, Help, Explain, Return (GATHER) framework. A total of 198 women participated in the study (response rate: 99.0%), including 80 women (40.4%) from JAFPP clinics and 118 (59.6%) from governmental clinics. In total, 42.9% of the counselling sessions were deemed adequate, with providers applying 80% or more of the GATHER framework, while 26.8% of the sessions were deemed semi-adequate and 30.3% were considered inadequate. Counselling services provided in the governmental clinics were significantly less adequate than those provided in JAFPP clinics ( P counselling services in governmental family planning centres in Jordan needs to be improved to ensure that women receive the highest possible level of care. Healthcare policymakers should therefore focus on developing and supporting effective family planning counselling services in northern Jordan.
International Planned Parenthood Federation, London (England).
This document gives highlights of the family planning situation in countries of the world, together with basic demographic statistics. Its purpose is to provide a quick reference source for those who work in family planning, population, and other related fields. Following a brief history of the pioneering work in family planning, population…
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
The impact of facility audits, evaluation reports and incentives on motivation and supply management among family planning service providers: an interventional study in two districts in Maputo Province, Mozambique.
Vermandere, Heleen; Galle, Anna; Griffin, Sally; de Melo, Málica; Machaieie, Lino; Van Braeckel, Dirk; Degomme, Olivier
only a monthly audit. During this study, more stock-outs occurred for family planning methods with lower demand, but the number of stock-outs per family planning method in the intervention groups was only significantly lower, compared with the control group, for female condoms. While a rise in motivation was not measurable, stock management was enhanced possibly as a result of the monthly audits. This activity was primarily for data collection, but was described as motivating and supportive, indicating the importance of feedback on health workers' accomplishments. More research is needed to quantify the additional impact of the interventions (distribution of evaluation reports and material incentives) on staff motivation and supply management. Special attention should be paid to supply management of less frequently used contraceptive methods.
National Environmental Education & Training Foundation, 2012
This document lays out the strategy for achieving the goals and objectives of NEETF's "Health Care Provider Initiative." The goal of NEETF's "Health Care Provider Initiative" is to incorporate environmental health into health professionals' education and practice in order to improve health care and public health, with a special emphasis on…
AJRH Managing Editor
Specifically, respondents were asked about availability of various kinds of family planning that included; combined oral pill, progestin-only pill, counseling on natural methods, male condom, female condom, intrauterine device, implant (6 rod, 1 rod,. Norplant, Implanon), spermicides, diaphragm, emergency contraceptive pill ...
for instance, Robey and colleaguesº asserted that strong commitment to the family planning pro- gramme by the government and donor organisa- tions, through efforts in changing attitudes towards contraception and provision of contraceptives, led to an increase in contraceptive use and fertility de- cline. Nigeria, as a result ...
three main themes across the studies: 1) individual factors behind contraceptive demand, 2) programmatic factors ... highlight three themes: 1) family planning and the. Millennium Development Goals, 2) evidence-based .... margin for improvement in service delivery, individual learning, and the research enterprise. In terms ...
Flagg-Williams, Joan B.; Rey, Janice M.
Mobile technology plays a prominent role in teaching and learning. To address this vital component of teacher preparation, the education department of a small college provided the freshman class with iPads. iPads were selected because they are common in public schools, lightweight, portable, touch-screen controlled and have an abundance of…
Community-based distribution projects are currently operating in 40 countries, including the program in Oyo State in southwest Nigeria. Such programs utilize volunteer community workers to expand the availability and accessibility of primary health care services, family planning information, and nonprescription contraceptives in rural areas. These workers play a vital role in linking the village with government health facilities. Among the responsibilities of community health workers are promotion of food supply and proper nutrition, adequate supply of safe water and sanitation, maternal and child health care (including family planning, immunization, prevention and control of major endemic diseases, treatment of common diseases, and provision of essential drugs). These workers are nominated by traditional village leaders and selected by public health nurses; priority is given to traditional birth attendants. In Oyo State, community workers participate in an extensive 2-phase learning program followed by refresher courses every 6 months. After 2 years of program services in Oyo State, approval of family planning increased from 20% to 50% and the desire to postpone the next pregnancy beyond the period of postpartum abstinence increased from 15% to 34%. Knowledge of a modern family planning method rose from 24% to 45%. Current use of contraception rose from 1.5% to 4.5%. Despite these gains, there has been a persistence of the traditional viewpoint that regards sex as primarily for the purpose of procreation. An additional barrier is the widespread belief among husbands that if women are protected from conceiving, they will engage in extramarital relations. These strong Yoruba cultural beliefs continue to restrict acceptance of family planning and pose a challenge to health workers.
Although pharmacies now dispense primarily modern products originating in large multinational corporations, the community pharmacist has not been replaced by any ultramodern technological advance. Many thousand persons acquire family planning products in pharmacies. The pharmacist works many hours a day, is always available, and provides free advice to his clients. Pharmacists are consulted daily on numerous topics, especially on family planning. Many prsons in rural areas are without the services of a physician and rely on pharmacists all the more. Pharmacists could orient the public on family planning in general, help in choosing the most appropriate of available methods, and refer patients to physicians in case of problems. Participants at the recent International Conference on the Role of Retail Pharmacists in Family Planning, held in Alexandria, Egypt, concluded that pharmacists should cooperate with physicians and other health professionals to provide family planning services and should participate in elaboration of laws regulating the manufacture, storage, prices, and distribution of contraceptives. The prices of contraceptive supplies to the consumer could be reduced if taxes and import duties were removed, if supplies were produced locally, or if supplies were subsidized by some donor organization.
Chandani, Y; Breton, G
Many developing countries increasingly recognize and acknowledge family planning as a critical part of socio-economic development. However, with few health dollars to go around, countries tend to provide essential drugs for curative care, rather than for family planning products. Donors have historically provided free contraceptives for family planning services. Whether products are donated or purchased by the country, a successful family planning program depends on an uninterrupted supply of products, beginning with the manufacturer and ending with the customer. Any break in the supply chain may cause a family planning program to fail. A well-functioning logistics system can manage the supply chain and ensure that the customers have the products they need, when they need them. Morocco was selected for the case study. The researchers had ready access to key informants and information about the Logistics Management Information System. Because the study had time and resource constraints, research included desktop reviews and interview, rather than data collection in the field. The case study showed that even in a challenging environment an LMIS can be successfully deployed and fully supported by the users. It is critical to customize the system to a country-specific situation to ensure buy-in for the implementation. Significant external support funding and technical expertise are critical components to ensure the initial success of the system. Nonetheless, evidence from the case study shows that, after a system has been implemented, the benefits may not ensure its institutionalization. Other support, including local funding and technical expertise, is required.
Cho, H; Shreshtha, P; Mawlong, M; Pestano, R; Wichiensharoen, K; Mobarez, N
Prominent women from Korea, Nepal, India, Philippines, Thailand, and Afghanistan discuss family planning attitudes in broad terms. Educated women in urban areas make decisions regarding birth control and family size, but the tradition in most developing countries is that of the man in the authority role. Family planning is intrinsically a joint decision. Obligations to family and family lineage prohibit family planning. In the Philippines, Catholicism is the dominant religion and because of population density, encourages family planning. For economic and social reasons, rural families prefer more children. The changing role of women to include jobs and education will have a positive effect on family planning. The representative from Nepal points out that it is necessary to have family planning in order to have changing women's roles. Rather than emphasizing smaller family size, it is recommended by concensus, that family planners communicate health and nutritional benefits for each individual child.
In Japan, the condom is the method of choice of 82% of all contraceptive users. The Japan Family Planning Association covers about 3% of the total condom market through a well-organized social marketing scheme. Mobile guidance teams, equipped with a vehicle, supply contraceptives to health centers, independent midwives, and maternity hospitals in 17 prefectures and collect payment for condoms distributed after their previous visit. As an incentive, organizations and health institutions receive a commission for the condoms they supply. Japan's largest condom manufacturer provides supplies to the Family Planning Association at a very low price. The contraceptive social marketing program pays for its own promotion, and the Family Planning Association is able to support its other activities from the income it earns. The program was designed to complement rather than compete with commercial marketing channels such as pharmacies, which supply 60% of the 660 million condoms purchased in Japan each year.
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.
The author provides a global review of family planning techniques and their impact on national birth rates. Sterilization, the pill, and intrauterine devices are the most popular methods of contraception worldwide. Abortion, where it is legal, is also extremely popular. In countries such as the United States where population control is not an…
Objective: In sub-Saharan Africa, many family planning programmes do not encourage advance provision of oral contraceptives to clients who must wait until menses to initiate pill use. Since some resistance to advance provision of pills is due to provider fears that the practice may be harmful, we conducted a study in Kenya ...
support at all levels of the public health system. The technical support includes training for service providers, including HEWs on different family planning methods, post ..... Kalutara district Siri Lanka. Int J Collaborative. Res Intern Med Public Health 2012;4(6):1097-114. 2. Cates W, Abdool Karim Q, El-Sadr W, Haffner D,.
Cost effectiveness studies of family planning (FP) services are very valuable in providing evidence-based data for decision makers in Egypt. Cost data came from record reviews for all 15 mobile clinics and a matched set of 15 static clinics and interviews with staff members of the selected clinics at Assiut Governorate.
Deliberate efforts should be made by the management of UCTH Calabar to train and retrain health services providers to equip them with knowledge, skills and new ideas required for the handling of clients with all types of FP problems. Keywords: Problems, Prospects, Family planning, Calabar Global Journal of Social ...
Little is known on integrating HIV and family planning (FP) services in community settings. Using a cluster randomized controlled design, we conducted a formative assessment in two districts in Uganda where community health workers, called VHTs, already offered FP. Thirty-six trained VHTs also provided HIV testing and ...
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.
Nguyen Thi Hue
The Vietnam Peasant Union encourages peasants to comply with the following criteria for the modern family: not having too many children, not being poor and starving, not having malnourished children and diseased women due to the bearing of too many children, being literate, not being superstitious, and not violating the law and State policy. 30% of the union's 7.5 million members have registered to abide by these rules. Peasants comprise almost 80% of Vietnam's total population. Although poor, peasant family incomes are increasing along with living conditions. Fertility remains too high. The Peasant Union has therefore been carrying out information, education, and communication and motivational activities among peasants so that peasants in general, and middle-aged heads of households in particular, will accept and practice family planning. For each province, the union produces teaching materials such as training packages for officers at provincial, district, and community levels, as well as a manual for field workers. The manual has two columns for respective topics: one explains a population and family planning item, while the other depicts a related agricultural activity.
Mexico's private, nonprofit social marketing company, known as PROFAM, intends to expand its family planning clinics to marginal urban areas. The clinics are part of PROFAM's push to diversify social marketing outlets for contraceptive products and other birth control methods. PROFAM expects to establish 3 new clinics, possibly including a pregnancy test laboratory, a small 1-doctor clinic, and a large clinic housing an operating room. 1 clinic will be located outside the Mexico City area, the program's traditional boundaries. The company currently runs 2 small clinics and a pregnancy testing laboratory in Ciudad Netzahualcoyti, a community of 3.5 million on Mexico City's outskirts. PROFAM recently obtaine d government approval to sell condoms in food stores, which should increase distribtuion and sales. Currently, the company sells over 1 million high quality, lubricated condoms each month, accounting for over half of the Mexican market. Distribution covers 85% of the country's drugstore. Program setbacks occurred in 1981, when the Mexican government cancelled PROFAM's sales permits for all contraceptive products except condoms. Cancelled products included an oral contraceptive and 3 vaginal spermicides. These 4 products had provided nearly 100,000 couple years of protection in 1979 and an estimated 120,000 CYP 1980. During 1979 and 1980, condoms provided about 27,000 and 60,000 CYP, respectively. PROFAM had relied heavily on the pill and spermicides because its early studies showed condoms had a negative image in Mexico, due largely to the product's association with extramarital affairs. To counter this, PROFAM launched a widespread, free product sampling program in 1979, along with a continuing educational and advertising drive. Subsequent consumer surveys revealed a marked increase in product acceptance, with PROFAM's condom becoming the most widely known brand available in Mexico.
-family planning users were included in a study to assess the factors that are associated with utilization of family planning services at different levels of health institutions in northwest Ethiopia. Despite for (more) children was the most common ...
Some results are provided from the 1991 Social Weather Survey conducted in 1991 for the Legislators' Committee on Population and Development. The sample included both males and females (84% Roman Catholic, 7% other indigenous Christians, 7% Protestants, 1.2% Muslims, 0.2% without a religion, and 0.1% Buddhists). Surprising findings are that the public does not feel restricted from using family planning methods due to religious rules, schooling teachings, or a physician's advice. Most people hold that politicians generally support family planning. Only 19% are reported to believe that governors are against family planning, and 16% report that their mayors are against family planning. According to stated voting intentions, incumbent government officials perceived to be anti-family planning risk not being reelected. 96% of the survey respondents believe that it is important to have control over one's fertility. Awareness of family planning methods is directly related to socioeconomic class, education, and urban location. 21% say that their religion forbids tubal ligation and 26% say that ligation should never be practiced. 22% say that their religion allows ligation. Among people who believe that religion bans ligation, 10% approve of ligation at any time and 44% stipulate that there are times when it may be practiced. Another interesting finding was that school teaching had more influence on beliefs than religion. When schools said that rhythm was not allowed, 40% agreed. When religion taught that rhythm was not allowed, only 21% agreed. 9% of persons who were sectarian educated and 5% among non-sectarian educated persons believed that ligation should not be practiced.
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 ...
Objective To review the acceptance pattern and the influence of age and parity on the choice of Family Planning Methods at the Family Planning Clinic, Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Method All records of the clients that attended the Family Planning Clinic from January 2003 to December 2007 ...
Background: Adoption of family planning by men or their spouses many times is influenced by men particularly in developing countries. This is despite evidence that reduction of maternal mortality and morbidity is tied to family planning use. In order to design programmes that enhance adoption of family planning methods ...
54.5%) had used a family planning method before with majority, 105(58.2%) using natural family planning method. Only 22.7% of the participants was using a family planning method at the time of the study. In majority of the women, ...
Background: Family planning improves community health and wellbeing by helping women to space and/or limit the number of children they want until they are ... to promote modern family planning utilization, partner participation, and couple counselling for join to decision making to improve modern family planning use.
Major motivating factors to the usage of family planning service were to space children, 94% (47/50) and to prevent pregnancy and sexual transmitted infections 84% (42/50). Major reasons for not accessing family planning services were opposition from husbands, 90% (207/230) and misconceptions about family planning, ...
Sources and nature of family planning information have been found to influence the use of family planning services. Unfortunately, the exact relationships between these variables and family planning utilization are not certain in Nigeria. This paper therefore searches for better understanding of the interrelationships, using ...
This study examined the knowledge level, attitude to and the practice of Family Planning among Airmen in Nigeria. It was hypothesized that knowledge of Family Planning, number of children and religion affect the use of Family planning. The study also identified socio-demographic variables and other factors associated ...
Three themes and categories emerged from the data analysis namely, commencement of family planning methods, different family planning methods in IK and bio-medicine. It was concluded that most of the community members still use IK family planning and it is of importance for health workers to address such issues ...
Ayten Senturk Erenel
Full Text Available Use of an family planning method during the postpartum period is important both to space births, and to prevent unwanted pregnancies. Under-utilization of family planning services during this period not only leads to adverse conditions caused by excessive fertility, but also has negative effects on both maternal and infant health. Women are in close contact with health care providers before, during, and after childbirth, when they are most likely to be impressed by the services they receive. Effective provision of health care services in these periods is therefore of great importance. Literature indicates high rates of success and compliance with family planning services provided during these periods. Many women neglect to use a modern contraceptive method in the postpartum period believing that breastfeeding alone ensures sufficient protection against pregnancy. Indeed, breastfeeding can be 98% effective as a contraceptive method; however, this is only true if certain criteria are observed. There are three basic criteria for the lactational amenorrhea method to be effective: the baby must be less than six months old, must be exclusively or almost exclusively breast-fed, and the mother must not be menstruating. In a conference held in Bellago in August 1988 by the World Health Organization and other international agencies, a consensus was developed for effective use of lactational amenorrhea method, and it was agreed to adopt breastfeeding as a potential family planning method in maternal and child health programs. [TAF Prev Med Bull 2010; 9(4.000: 383-390
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)
Vietnam's economy began to grow after the December 1986 implementation of Doi Moi policy, with the gross domestic product increasing by more than 5% annually since 1990. Per capita GNP has increased to US$220. In 1989, Vietnam achieved self-sufficiency in rice production and became the world's third largest exporter of rice, the infant mortality rate is 42 per 1000 live births, the average life expectancy is 65 years, and 88% of people aged 10 years and older are literate. Vietnam's economy is expected to continue to grow. However, population growth is a major constraint to Vietnam's projected steady economic and social development. The total population grew from 15.5 million in 1921 to 74 million in 1995. A high unemployment rate and urbanization are already issues. Doi Moi policy therefore gives top priority to the Population and Family Planning (PFP) Program. The overall objective of the PFP policies is to achieve small and healthy families conducive to a happy and prosperous life. Specifically, it hopes to realize each family with one or two children so that by the year 2015 the average number of children for each family will be only two. Policy aims to stabilize Vietnam's population by the year 2050.
Full Text Available Objectives: 1. To evaluate the role of Lactational Amenorrhea Method (LAM as a spacing method. 2. To assess knowledge attitude and practices regarding breastfeeding. 3. To bring awareness regarding importance of breastfeeding on child health and as a method of family planning so that exclusive breast feeding is promoted. Study Design: Cross sectional study. Setting: In rural village of district Wardha. Study Universe : All the lactating mothers who had2 children (one of which was less than 3 years. Study Variables: Duration of Breast Feeding, LAM, Importance of Breast Feeding. Knowledge of Colostrum, Awareness of Breast Feeding, etc. Statistical analysis used: Percentages and proportions. Result: A total 42 families were included in the survey of which 26 (61.9% belongs to nuclear families with majority of the women 19(45.2% in the age group of 20-25 yrs, 20 (47.6% were illiterate and 18(42.8% families were of lower Socio Economic Status. A directly proportional relationship was found between duration of Breastfeeding & LAM and period of LAM & age of youngest child when the mother delivered again. Only 31% knew about the importance of breastfeeding. 16.6% of woman initiated Breast Feeding within 1/2 hr.
Au, Selena S; Roze des Ordons, Amanda; Soo, Andrea; Guienguere, Simon; Stelfox, Henry T
To describe and compare intensive care unit (ICU) patient family member and provider experiences, preferences, and perceptions of family participation in ICU rounds. Cross-sectional survey of ICU family members and providers of patients admitted to 4 medical-surgical ICUs from September 2014 to March 2015. Surveys were completed by 63 (62%) family members and 258 (43%) providers. Provider respondents included physicians (9%), nurses (56%), respiratory therapists (24%), and other ICU team members (11%). Although 38% of providers estimated only moderate family member interest in participating in rounds, 97% of family members expressed high interest. Family members and providers reported listening (95% vs 96%; P=.594) and sharing information about the patient (82% vs 82%; P=.995) as appropriate roles for family members during rounds, but differed in their perceptions on asking questions (75% vs 86%; P=.043) and participating in decision making (36% vs 59%; P=.003). Compared with family members, providers were more likely to perceive family participation in rounds to cause family stress (7% vs 22%; P=.020) and confusion (0% vs 28%; PFamily members and providers share some perspectives on family participation in ICU rounds although other perspectives are discordant, with implications for communication strategies and collaborative decision making. Copyright © 2016 Elsevier Inc. All rights reserved.
externally-imposed improvements. Availability of family planning services becomes an important factor in the extent and speed of fertility decline once the desired number of surviving children becomes smaller than that implied in a natural fertility regime. The author found that sustained fertility declines were usually preceded by mortality declines, but improved health conditions did not automatically lead to fertility declines. The pronatalist attitudes of individual households, rational though they might be, are becoming a problem for African governments burdened by the need to provide services for ever growing populations. Lloyd and Ivanov believe that infant mortality is still too high in most of Africa to encourage family planning; they recommend that sterilization be stressed for families that have achieved their desired size. This work argues however that a future fertility decline is not assured and that reversible contraceptives should be available for the population sectors desiring them.
Buijs, Paul; Lopez Alvarez, Jose Alejandro; Veenstra, Marjolein; Roodbergen, Kees Jan
We study the collaborative transport planning for two autonomous business units of Fritom, a Dutch logistics service provider. This difficult planning problem does not fit any existing type of vehicle routing problem proposed in the academic literature; therefore, we define a new problem class, the
Background: Providing quality of care in family planning services is an important task for care providers so as to increase service utilization and coverage; however, little is known about the existing quality of care in such services. Objective: To assess quality of care in family planning services in Jimma Zone, southwest ...
Butt, H W
In order to increase the motivation and skills of doctors at Mission hospitals throughout India in the latest methods of family planning, 10 advanced courses were given in 1971-1972. The courses represented the combined efforts of the Family Planning Association of India, which sponsored the team of experts, the Indian government, which mobilized agencies and communities to volunteer cases for sterilization, and the Christian Medical Association, which took care of the organizational details. Each course is made up of 4 parts: presentation of a brief theoretical framework; an opportunity for discussion and exchange of ideas and experience; practical demonstrations by the experts of different types of operations for male and female sterilization; and the active participation of each individual by performing operations under expert guidance. 648 doctors and technical personnel have taken advantage of the advanced courses in some way. Efforts at evaluating the effectiveness of the courses by the participants themselves have not been too successful as they often do not bother to complete the evaluation sheets. However, the views of those who did respond are presented.
Since the 3rd plenary session, the Party Central Committee and the State Council of China have attached great importance to family planning work, pointing out that the population has always been an extremely important issue in China's economic and social development. Characteristics that clarify China's situation are 1) a low level of industrial and agricultural production and the underdevelopment of economy and culture, 2) a large population with a young age composition, 3) a vast territory with conditions differing tremendously in various places, and 4) a predominantly rural population with feudal ideological influences--such as boys are superior to girls--that are relatively deep-rooted. The total fertility rate of childbearing age women in 1983 was 2.07 which, when compared with 5.68 in the 1960s and 4.01 in the 1970s, dropped 3.61 and 1.97 respectively. This growth rate is already lower than their population replacement rate, and is much lower than that of developing countries. Governments at all levels and related departments, all people's organizations, and all professions and trades now regard family planning as a part of their own work; unlike the old days, the concept of childbirth has greatly changed among the masses after years of publicity and practice in family planning. A nationwide scientific research network for family planning is now taking shape; in contraception and birth control, the types and model sizes of IUDs and oral drugs of domestic make are relatively complete.
Albania's entrance into the world community has exposed some of the consequences of a pronatalist policy of 40 years; high infant and maternal mortality, illegal clandestine abortions leading to morbidity and death, and high fertility at 3.3 children per woman in 1990. The crude birth rate was 25.2 per 1000. The communist dictator Enver Hohxa used extreme measures with his secret police to enforce repressive policies. Birth control was forbidden to be even discussed, and sex was absent from medical literature. The current population of Albania is 3.3 million, with 66% living in remote mountain villages. A national family planning program is currently underway. The goals are to reduce mortality, reduce premature births by 20%, and achieve contraceptive usage among 10% of the reproductive age populations. Medical personnel will be trained in family planning, and family planning will be introduced in the entire health education program. Reliance will be placed on the existing extensive system of primary health care (PHC) facilities. The outreach effort to the 700,000 women of reproductive age will involve all health care professionals. Information, education, and communication will be the main thrust of the program. A model family planning clinic will be established at the Maternity Hospital at Tirana, which already has a teaching capacity for training of medical students, midwives, and nurses. Although a PHC system is in place, buildings and equipment are out of data. The health personnel of the program are excited by the challenge of providing reproductive health care for an woman's entire reproductive life. A new family planning clinic has already been established in Elbasan, a remote village south of Tirana, but public response has been mixed. Another clinic north of tirana has a population that is enthusiastic about family planning, even with a clinic not as well equipped as in Elbasan. The educational outreach must include doctors as well, who have only read
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.
80% of women using contraception in Zambia use oral contraceptives (OCs), yet they often complain about side effects. 66% of people polled at family planning (FP) clinics prefer OCs and 30% chose condoms. Nevertheless only 10% of the 60% of married couples familiar with FP use contraception. This contributes to Zambia having 1 of the highest annual population growth rates in the world (3.4%). The Planned Parenthood Association of Zambia (PPAZ) thinks that if males become more knowledgeable about FP, the population growth would slow down. At least 60% of men in Zambia approve of their wives using FP, yet they are slow to use male contraception. They say condoms reduce sensation and wives often consider condoms a nuisance. The AIDS epidemic forces men to rethink their views toward condom use, however. Those 30% of men who do use condoms are more likely to use them with their girlfriends or women with whom they are unfamiliar. So they are not using them for FP purposes. Men fear vasectomy because they perceive it to cause impotence. Considerable education to counter this myth is needed to increase the number of vasectomies. Besides some men prefer their wives be sterilized rather than themselves because if the men lose all their children they can have other children with other wives. PPAZ aims programs at men in order to expand their participation and nurture their influence in FP matters. It has a male counseling program serving rural villages along the railroad lines which begin in the northern copper belt and end in urban areas in the south to promote birth spacing. It is working with companies to include FP services in their clinics so men can learn more about FP. FP specialists in Zambia foresee an increase in male support of FP as they realize the difficulty of supporting large families during the economic crises.
It is imperative to make family planning more accessible in low resource settings. The poorest couples have the highest fertility, the lowest contraceptive use and the highest unmet need for contraception. It is also in the low resource settings where maternal and child mortality is the highest. Family planning can contribute to improvements in maternal and child health, especially in low resource settings where overall access to health services is limited. Four critical steps should be taken to increase access to family planning in resource-poor settings: (i) increase knowledge about the safety of family planning methods; (ii) ensure contraception is genuinely affordable to the poorest families; (iii) ensure supply of contraceptives by making family planning a permanent line item in healthcare system's budgets and (iv) take immediate action to remove barriers hindering access to family planning methods. In Africa, there are more women with an unmet need for family planning than women currently using modern methods. Making family planning accessible in low resource settings will help decrease the existing inequities in achieving desired fertility at individual and country level. In addition, it could help slow population growth within a human rights framework. The United Nations Population Division projections for the year 2050 vary between a high of 10.6 and a low of 7.4 billion. Given that most of the growth is expected to come from today's resource-poor settings, easy access to family planning could make a difference of billions in the world in 2050.
Varner, Derrick F; Foutch, Brian K
This study investigated the prevalence of depression and burnout symptoms among family medicine providers on active duty in the US Air Force. Results demonstrated that 84% of those surveyed scored positive for degrees of depression symptoms; only sex differences were significant.
Wang, Fei; Zhao, Liqiu; Zhao, Zhong
China initiated its family planning policy in 1962 and one-child policy in 1980 and allows all couples to have two children as of 1st January, 2016. This paper systematically examines the labor market consequences of China's family planning policies. First, we briefly review the major historical evolution of China's family planning policies. Second, we investigate the effects of these policies on the labor market, focusing on the size and quality of the working-age population and its age and ...
Mcwilliam, J A
In reviewing the effort of research workers in model testing with special reference to determinants of contraceptive usage, this paper draws on 2 fertility case studies in urban Ghana and central India. A brief description of path analysis technique, a special form of regression analysis, is given (weights are assigned to each variable for optimal prediction). In applying this technique to the case studies, the author notes some similarities in the adoption of family planning. This conclusion applies to education and income as a factor in the Indian case, and education and household status factors in the case of Ghana. In the case of India the effect is direct; for Ghana it is considered indirect. The advantages of path analysis technique include: 1) its flexibility in analyzing data in the most frequently arising circumstances, namely where an interval scale or dichotomous (dependent) variable is to be understood; 2) its ability to bridge the gap between sociological theory and statistical analysis. However, drawbacks in using regression models in testing social theories and models must be considered. Multiple regression assumes a 1 way scheme of cause and effect; a linear relationship between variables is also assumed but not always substantiated by reality e.g., family size may not change with socioeconomic status; types of data suitable for use is usually limited to ratio or interval data but social scientists frequently analyze nominal data such as religion, ethnic group or residence. In both the Ghanaian and Indian study, the data were not originally collected with the intention of performing a path analysis. However with both studies an initial attempt to test models in fertility/family planning behavior was made that is useful to the understanding of how the hypothesized relationships between variables in these models stand up to sophisticated statistical procedures. Tables accompanying the text include Mishler and Westoff's conceptual model for fertility
Roberts, Kimberly S
Current health care policy mandates that the unique health needs of various cultures be met and barriers to health care minimized. Birth occurs in the context of culture and religion, and an understanding of culture and religious beliefs are important for health care providers who are challenged to provide culturally sensitive care to diverse populations. This article provides a broad background discussion of Islam for the non-Muslim. A discussion of the care of the Muslim family during the childbearing process, highlighting specific issues related to modesty and privacy, female traditional dress and covering, dietary requirements, and newborn care, are provided. Part 2 in the series will present unique risk factors, health care beliefs, breast-feeding practices, issues related to end-of-life decisions and withdrawal of support, and death rituals that may be unique to Muslim families.
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 ...
family planning. Seminars were held with authorities from different sectors, during which ways were suggested of incorporating population communication into their usual activities. After some preliminary difficulties with Catholic health centers, which account for almost 1/2 of the health facilities in Gikongoro, the idea of family planning began to gain acceptance, on the condition that all contraceptive methods including natural methods be included. Much opposition to family planning still exists at the level of the base population. By 1986, 8 state and 3 protestant health centers were offering family planning services in Gikongoro. The number of women using contraception increased from 400 to 1600. Injectable methods are preferred. The frequent side effect of amenorrhea is welcomed because of the prevalence of anemia. Family planning training was provided for health personnel at all levels.
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.
Wambui, T; Ek, A-C; Alehagen, S
Men have rarely been involved in either receiving or providing information on sexuality, reproductive health or birth spacing. They have also been ignored or excluded in one way or the other from participating in many family planning programmes as family planning is viewed as a woman's affair. To describe the perceptions of family planning among low-income men in Western Kenya. A qualitative study using focus group interviews and content analysis was conducted, with 64 men aged 15-54 years participating actively. Perceptions of family planning were manifold. For example, some perceived it as meaning having the number of children one is able to provide for. Most men knew about traditional and modern methods of birth control, although their knowledge was poor and misconceived. Modern methods were thought to give side effects, discouraging family planning. Low instances of family planning were also because of the fact that culturally, children are considered wealth. A law advocating family size limitation was regarded as necessary for the future. Men's perceptions of family planning are manifold. Their knowledge about contraception is poor and sometimes misconceived. Preferences regarding a child's gender are strong, thus attitudes and cultural beliefs that might hinder family planning have to be considered. A policy on male contraception and contraceptive services is seen as necessary.
Boyd, Jamie M; Burton, Rachael; Butler, Barb L; Dyer, Dianne; Evans, David C; Felteau, Melissa; Gruen, Russell L; Jaffe, Kenneth M; Kortbeek, John; Lang, Eddy; Lougheed, Val; Moore, Lynne; Narciso, Michelle; Oxland, Peter; Rivara, Frederick P; Roberts, Derek; Sarakbi, Diana; Vine, Karen; Stelfox, Henry T
The aim of this study was to develop and evaluate the content validity of quality criteria for providing patient- and family-centered injury care. Quality criteria have been developed for clinical injury care, but not patient- and family-centered injury care. Using a modified Research AND Development Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Methodology, a panel of 16 patients, family members, injury and quality of care experts serially rated and revised criteria for patient- and family-centered injury care identified from patient and family focus groups. The criteria were then sent to 384 verified trauma centers in the United States, Canada, Australia, and New Zealand for evaluation. A total of 46 criteria were rated and revised by the panel over 4 rounds of review producing 14 criteria related to clinical care (n = 4; transitions of care, pain management, patient safety, provider competence), communication (n = 3; information for patients/families; communication of discharge plans to patients/families, communication between hospital and community providers), holistic care (n = 4; patient hygiene, kindness and respect, family access to patient, social and spiritual support) and end-of-life care (n = 3; decision making, end-of-life care, family follow-up). Medical directors, managers, or coordinators representing 254 trauma centers (66% response rate) rated 12 criteria to be important (95% of responses) for patient- and family-centered injury care. Fewer centers rated family access to the patient (80%) and family follow-up after patient death (65%) to be important criteria. Fourteen-candidate quality criteria for patient- and family-centered injury care were developed and shown to have content validity. These may be used to guide quality improvement practices.
Hulme, Jennifer; Dunn, Sheila; Guilbert, Edith; Soon, Judith; Norman, Wendy
Contraceptives are underutilized in Canada, and nearly one in three Canadian women will have an abortion in her lifetime. To help delineate a national family planning research agenda, the authors interviewed healthcare providers and organizational stakeholders to explore their perspective on barriers to contraception across regions of Canada. Semi-structured interviews were conducted based on validated frameworks for assessing family planning access and quality. The authors purposefully selected 14 key stakeholders from government agencies, professional organizations and non-governmental organizations for in-person interviews. Fifty-eight healthcare providers and representatives of stakeholder organizations in reproductive health who self-selected through an online survey were also interviewed. Transcripts were analyzed for repeated and saturated themes. Cost was the most important barrier to contraception. Sexual health education was reported as inconsistent, even within provinces. Regional differences were highlighted, including limited access to family physicians in rural Canada and throughout Quebec. Physician bias and outdated practices were cited as significant barriers to quality. New immigrants, youth, young adults and women in small rural, Northern and Aboriginal communities were all identified as particularly vulnerable. Informants identified multiple opportunities for health policy and system restructuring, including subsidized contraception, and enhancing public and healthcare provider education. Sexual health clinics were viewed as a highly successful model. Task-sharing and expanded scope of practice of nurses, nurse practitioners and pharmacists, alongside telephone and virtual healthcare consultations, were suggested to create multiple points of entry into the system. Results underscore the need for a national strategic approach to family planning health policy and health services delivery in Canada. Copyright © 2015 Longwoods Publishing.
Full Text Available For families that are not capable to obtain necessary supplies to meet their needs, State’s social policy guidelines determine support for improving the quality of life for these families. However, it is concluded, that neither the state nor municipality’ provided support for families with children with special needs, does not meet the needs of families, because state social policy is not focused on the assessment of the family needs, as well as often families do not receive the support due to lack of necessary information and disinterest by social service workers, which in turn reflects the problems in social policy delivery mechanisms. The most necessary support that families need is concerned with lodging and financial security, lack of assistants/care at home, as well as – emotional support.
Full Text Available Family planning services in Nepal are provided by government and non-government health facilities. A descriptive cross sectional study was done by secondary data review of eight months from Institutional clinic, District Health Office (DHO Ilam district. Use of different family planning methods through government health facility was studied in relation to different variables like age, sex, ethnicity, and, number of children. Around 53% of the female users of spacing method and around 47% of female users of permanent method were in age group 20-29 years and 25-29 years respectively. The major reasons for removal of IUCD were husband’s migration and experienced physical problems. Most of the females doing sterilization were from Disadvantaged Janajati group whereas most of the males doing sterilization were from Upper caste ethnic group. Among females doing sterilization, 70% already had their second live birth baby. Out of the total sterilization performed in 8 months, only 15.15% was done among males. So, there is need of increasing male involvement in Family planning. There is also need of programs to encourage spacing methods among the target population. DOI: http://dx.doi.org/10.3126/dsaj.v6i0.8482 Dhaulagiri Journal of Sociology and Anthropology Vol. 6, 2012 125-138
National Centre for Vocational Education Research (NCVER), 2015
This good practice guide is intended to assist public and private registered training organisations (RTOs) planning to commence higher education (HE) delivery. The guide is based on research undertaken by Victor Callan and Kaye Bowman, who completed case studies with six providers currently delivering higher education qualifications in addition to…
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…
The Jamaica Family Planning Association started holding presentations and discussions in the workplace in January 1986, now reaching 8000 people in 32 companies. The firms are primarily manufacturers (21) and hotels(7), but also include publishing, construction, printing and supermarket businessess. In these companies as well as many of the 480 members of the Jamaica Chamber of Commerce, employees are usually women of reproductive age who cannot afford to take time off to attend a clinic. There is a great demand for information and discussion on sexually transmitted diseases and clarification of the contraindications of various contraceptive methods. At the end of the discussions, educators offer pills, condoms and neo-sampoon, and may refer people for clinical services. Almost new acceptors have been recruited. The success of the project depends heavily on cooperation of management, supervisors and union representatives. In some cases union representives or company nurses act as distributors of contraceptives. This project has been so successful that some companies expressed an interest in participating in the Associations's resource development program.
Levin, Amanda B; Fisher, Kiondra R; Cato, Krista D; Zurca, Adrian D; October, Tessie W
To identify areas for improvement in family-centered rounds from both the family and provider perspectives. Prospective, cross-sectional mixed-methods study, including an objective measure (direct observation of family-centered rounds) and subjective measures (surveys of English-speaking families and providers) of family-centered rounds. PICU in a single, tertiary children's hospital. Families of children admitted to the PICU, physicians, and nurses. None. Two hundred thirty-two family-centered round encounters were observed over a 10-week period. Family-centered round encounters averaged 10.5 minutes per child. Multivariable regression analysis revealed that family presence was independently associated with length of family-centered rounds (p family talk time accounting for an average of 25 seconds (4%) of the encounter. Non-English-speaking families were less likely to attend family-centered rounds compared with English-speaking families even when physically present at the patient's bedside (p families and providers agreed that family-centered rounds keep the family informed and reported positive statements about family presence on family-centered rounds; however, PICU fellows did not agree that families provided pertinent information and nurses reported that family presence limited patient discussions. The primary advice families offered providers to improve family-centered rounds was to be more considerate and courteous, including accommodating family schedules, minimizing distractions, and limiting computer viewing. Family presence increased the length of family-centered rounds despite a small percentage of time spoken by families, suggesting longer rounds are due to changes in provider behavior when families are present. Also, non-English-speaking families may need more support to be able to attend and benefit from family-centered rounds. Lastly, in an era of full family-centered rounds acceptance, families and most providers, except fellows, report benefit
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 ...
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 ...
INTRODUCTION. Family planning implies the ability of individuals and couples to anticipate and attain their desired number of children by spacing and timing their births. It is achieved through the use of contraceptive methods and the treatment of involuntary infertility. The availability of family planning does more than ...
AJRH Managing Editor
Family Planning in Northern Nigeria. African Journal of Reproductive Health December 2013; 17(4):107. SHORT REPORT. Awareness, Use, and Unmet Need for Family Planning in Rural. Northern Nigeria. Henry V. Doctor*. 1,2. Sally E. Findley,. 3. Godwin Y. Afenyadu,. 4. Charles Uzondu. 5 and. Garba M. Ashir. 6.
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 ...
Kim, Young Mi; Kols, Adrienne; Mwarogo, Peter; Awasum, David
Comparisions of family planning sessions in Kenya found distinct gender differences in reasons for visiting the clinics and communication styles of both the clients and the counselors. These communication patterns may be a result of Kenyan gender roles and men's and women's different reasons for seeking family planning services. Implications of…
Current reports indicate that male participation improves uptake of maternal healthcare and family planning services among women. Objective: To determine factors that influence male participation in family planning services in Kenya. Design: A retrospective study. Setting: Nationally representative survey of Eight provinces ...
AJRH Managing Editor
To achieve the improved maternal and child outcomes of birth spacing, family planning in the postpartum period is essential. The objective of this study is to determine the perceptions regarding programmatic aspects of postpartum family planning by key informants in 17 countries determined to have high unmet need for ...
Family planning has profound sexual and reproductive rights implications which have been recognised over the years at several international conferences. Access to family planning is a major approach to maternal mortality reduction. Social and political factors, such as religion and politically-motivated funding restrictions ...
Of all unintended pregnancies, 39.6% (44) and 18.9% (21) were reported to have occurred in association with using contraceptive methods and in relation to poor quality of family planning services, respectively. This study has indicated the need for intervention to improve the quality of family planning services in the study ...
, such as natural family planning (4.7%), the vaginal ring (3.3%) and male or female sterilisation (2.8%), can prevent STIs. Married status was associated with current use of contraceptives, and having been formally taught about family planning ...
The use of modern family planning methods in developing countries is low. Among reasons for low uptake is religious belief on procreation. This study was designed to assess the knowledge and attitude of family planning among religious leaders in Ogbomoso metropolis of Oyo State, Nigeria. The study is a descriptive ...
Though most of all the respondents, 292 (72.5%) opined that decisions on family planning practice should be jointly reached by the couple and many, 202 (50.1%) remind their wives to use contraceptive, only 91 (22.6%) attended family planning clinics with their wives. The results showed that though many of the male civil ...
AJRH Managing Editor
predictors were locality, fear of side effects and geopolitical zones in both the 2007 and 2012 surveys though with some variations. The level of family planning use ... explained as the extent and composition of potential demand for modern family planning ... These barriers include lack of awareness, lack of access, cultural ...
Family Planning Clinic, University College Hospital, Ibadan, Nigeria. Okunlola M.A Owonikoko K. M; Adekunle .A 0 and ... 1995 only 8% family planning clinic clients opted for Norplant, their reasons for its choice was based .... introductory clinical trials of Norplant implants. A comparison of seventeen countries experience.
Knowledge, attitude and practice of family planning following termination of pregnancy among Basotho women at Queen Elizabeth II Hospital, Maseru, Lesotho. ... It is essential that the Ministry of Health and Social Welfare (MOHSW) be involved in promoting health education about the importance of family planning and the ...
Family planning is regarded as an important preventive measure against maternal and child morbidity and mortality. This study was aimed at determining the knowledge, attitude and use of family planning methods among women attending antenatal clinic in Jos; factors that militates against use of contraceptive methods ...
Childbearing and family planning choices of women living with HIV and AIDS: the lived experiences. ... E Nunkwe, J Mwanza, C Nzala, B Michelo Chi ... spread among women of childbearing age, there is an increasing need for support programs for infected women regarding sex, safer sex, pregnancy and family planning.
A total of 334 Nigerian, non-pregnant women, living in a high density, low-income urban area of Enugu, Nigeria, were interviewed on knowledge, attitude and practice of family planning. About 97.6% were found literate. Knowledge and approval of family planning was high, 81.7% and 86.2% respectively, but the practice of ...
... very few women had adequate knowledge about family planning methods. The study also revealed that women perceived family planning as a welcomed strategy to control population and make mothers healthy and strong after child birth, however, fear of pushing their husbands outside and increased promiscuity as well ...
Latin America and the Caribbean (2.2). More than 100 million women in less developed countries, or about 17 percent of all married women, would prefer to avoid a pregnancy but are not using any form of family planning. Currently, approximately 24.8 percent of African women have unmet needs for family planning; this ...
Background: Men are powerful decision makers especially in developing countries. Their permission and support are required for women to access family planning services. This study was conducted to assess the predictors of family planning awareness and practice among married men in a semi-urban community in ...
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 ...
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.
the individual’s experiences. The individual describes the experiences for the researcher and then the researcher interprets the narration given by...after becoming instructors. Learned from a profession instructor. I called our director of natural family planning. She sat down and showed me films ...planning and sex selection: Fact or fiction ? American Journal of Obstetrics and Gynecologv. 165,1982-1984. Natural Family Planning 73 Guida, M. (1999
Valadez, J J; Transgrud, R; Mbugua, M; Smith, T
This report demonstrates the use of Lot Quality Assurance Sampling (LQAS) to evaluate the technical competence of two cohorts of family planning service providers in Kenya trained with a new curriculum. One cohort had just finished training within two months of the study. The other cohort was the first group trained with the new curriculum about one year before the study. LQAS was adapted from industrial and other public health applications to assess both the individual competence of 30 service providers and the competence of each cohort. Results show that Cohorts One and Two did not differ markedly in the number of tasks needing improvement. However, both cohorts exhibited more tasks needing improvement in counseling skills as compared with physical examination skills or with all other skills. Care-givers who were not currently providing services accounted for most service-delivery problems. This result suggests that providers' use of their skills explains their ability to retain service-delivery skills learned in training to a greater degree than does the amount of time elapsed since they were trained. LQAS proved to be a rapid, easy-to-use empirical method for management decisionmaking for improvement of a family planning training curriculum and services.
China's family planning program is described in reference to its goals, approaches, and achievements. Between 1949-83, China's population increased from 541 million to 1,024,950,000. The population has a young age structure, and the median age is 22.9 years. 80% of the population is rural, and 90% of the population lives in the southeastern region of the country. In view of this demographic situation, the government recognizes the need to control population growth. China's goals for the year 2000 are to increase industrial and agricultural input by 400% and to keep population size below 1.2 billion in order to ensure that per capita income increases. In accordance with these goals, the government, in 1979, began advocating a 1-child policy. To ensure the survival of single children, the government also launched a program to upgrade maternal and child health (MCH). In some rural areas and among certain minority groups, the 1-child restriction is not applied. Family size goals will vary with time. These variations will reflect the need to maintain a balance between economic growth and population growth. A variety of incentives are used to promote the 1-child family. For example, single children receive medical and educational benefits, and in some rural areas, the parents of single children can obtain additional land contracts. Economic disincentives are also used. The government seeks to obtain compliance with the policy primarily through educating the public about the consequences of uncontrolled population growth. All channels of the mass media are used to deliver the messages, and the publicity campaign is especially intensive in rural areas. A comprehensive plan to provided family planning and population education for middle school students is currently being implemented. Each local area develops its own fertility control plan. This plan is then incorporated into the nation's overall plan and the overall plan is implemented from above. Family planning workers
Because of the change in accounting regulations that requires accrual for certain medical malpractice claims, healthcare providers could soon be experiencing significant effects on their financial results. AICPA Statement Position 87-1, "Accounting for Asserted and Unasserted Medical Malpractice Claims of Health Care Providers and Related Issues," states that if healthcare providers have not transferred all risk for medical malpractice claims arising out of occurrences prior to the financial statement date to a third party, some accrual will be required. Providers need to prepare themselves for the financial problems that could arise from these reporting guidelines. Estimating the potential accrual amounts with advanced planning and extensive data gathering and analysis could lower a healthcare provider's financial risk.
Full Text Available Strategies to accelerate progress of India′s family planning programme are discussed and the importance of improving the quality and reach of services to address unmet contraceptive need by providing method choice is emphasized. Although there is a growing demand for both limiting and spacing births, female sterilisation, is the dominant method in the national programme and use of spacing methods remains very limited. Fertility decline has been slower in the empowered action group (EAG s0 tates which contribute about 40 per cent of population growth to the country and also depict gloomy statistics for other socio-development indicators. It is, therefore, important to intensify efforts to reduce both fertility and mortality in these s0 tates. a0 rationale has been provided for implementing integrated programmes using a gender lens because the lack of women′s autonomy in reproductive decision-making, compounded by poor male involvement in sexual and reproductive health matters, is a fundamental issue yet to be addressed. The need for collaboration between scientists developing contraceptive technologies and those implementing family planning services is underscored. If contraceptive technologies are developed with an understanding of the contexts in which they will be delivered and an appreciation of end-users′ needs and perspectives, they are more likely to be accepted by service providers and used by clients.
Macqueen, I A
Recommendations on community family planning services are made by an Aberdeen Medical Health Officer. It is noted that: 1) both GPs and clinics have their value in contraceptive treatment; 2) clinics should be conveniently located and might be set up in buildings which are used for other health purposes at other times; 3) most women work so there should be evening sessions; 4) arrangements should be made which include both an appointments system and emergency visits; 5) reception at the clinic should be courteous and without moral judgements; 6) domiciliary services should be used only as a last resort; and 7) payment of prescription charges is now required, but there might be advantages in changing this to a free service. The ideal person for motivating people to use the service is the health visitor. More health visitors are needed, salaries and promotions must be raised, and enrolled nurses should be recruited to act as assistants to health visitors. Benefits of the Aberdeen community family planning services are described. Such services increase the happiness of the community and save the community a considerable amount of money.
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.
Mutair, Abbas Saleh Al; Plummer, Virginia; O'Brien, Anthony Paul; Clerehan, Rosemary
This article aims to increase an awareness of caring for Saudi families by non-Saudi nurses to improve their understanding of culturally competent care from a Saudi perspective. Healthcare providers have a duty of a care to deliver holistic and culturally specific health care to their patients. As a consequence of 'duty of care' obligations, healthcare providers must facilitate culturally congruent care for patients of diverse cultural backgrounds. For the Saudi family considerable cultural clashes may arise when Saudi patients are hospitalized and receive care from healthcare professionals who do not understand Islamic principles and Saudi cultural beliefs and values. The healthcare workforce in Saudi Arabia is a unique multicultural workforce that is mix of Saudi and significant other nationalities. Saudi nurses for example represent only 36.3% of the workforce in the different health sectors. Whilst the different ethnic and cultural background expatriate nurses represent 63.7% (Ministry of Health, 2010). This article also could increase the awareness of healthcare professionals caring for Arab and Muslims patients in another context in the world.
This is the final article in a series on a survey of 710 couples who consulted for family planning in Lyons and Paris in 1968, Agreement before marriage on planned family size was correlated with success in achieving this plan, especially in the young, well educated, and in rightists. The number of children was directly related to desired family size, but a large proportion of those without a plan had uuplanned children. Factors tending toward larger desired family size were religious practice, higher education, and income. Factors associated with larger existing families were lower education and income, religous practice, female unemployment, longer duration of marriage, and use of traditional contrceptive methods. Among those with only elementary education, the proportion with 3 or more children remained constant with rising income, but among those with postsecondary education the proportion of large families was closely correlated with income. Couples who considered their families complete or who considered their family planning successful were overrepresented by the well educated, while couples with incomplete families or characterized by imperfect planning were more often secondary school graduates. Success in family planning was only apparent in many cases, since these results were often achieved by abortion.
Arokiasamy, J T
A study was conducted at the Army Garrison Hospital at Port Dickson in Peninsular Malaysia to determine the attitudes of 110 married men towards family planning. The sample included 80 Malays and 30 Indians who are army personnel attending the hospital either for medical treatment or a check-up. The study instrument was a pre-tested questionnarie administered by 2 male nurses during the November-December 1975 period. 76 of the respondents were between the ages of 20-34 years. 81 of the respondents had been married for a duration of up to 11 years. A breakdown by religion showed that 80 were Muslims, 25 were Hindus, and 5 were Christians, the latter being all Roman Catholics. All of the respondents were able to read and write in at least 1 language, 36 had had schooling varying from standard 1-6, 40 had had schooling varying between Form 1-Form 3, and 34 had had schooling varying from Form 4-to either Malaysian Certificate of Education Level or Higher School Certificate Level. 103 of the respondents approved of family planning, and of these 63 had always felt this way in the past. 6 respondents indicated that they had not thought about family planning in the past. 87 respondents did not approve of the practice of family planning before having the 1st child. Only 7 of 80 Malays in contrast to 16 of 30 Indian respondents -- a significant difference -- approved of family planning before the 1st child. 89 of the 110 respondents had discussed family planning with their wives; 21 respondents had not. 93 respondents disapproved of induced abortion; 17 approved of it. Only 3 of 80 Malay respondents approved induced abortion, but 14 of 30 Indian respondents indicated approval. 98 of the respondents indicated that they were interested in learning more about family planning, and 96 approved of their wife practicing family planning. 56 respondents were practicing family planning, and 20 indicated that they would do so in the future. 6 said they would not practice family
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.
Akers, Aletha Y.; Schwarz, Eleanor Bimla; Borrero, Sonya; Corbie-Smith, Giselle
CONTEXT Parent-adolescent communication is associated with increased adolescent contraceptive use. However, studies of this association are limited by their lack of examination of the communication process, reliance on cross-sectional designs and infrequent comparison of parent and adolescent perspectives. Examining communication in black families is particularly important, given the high pregnancy rate among black adolescents. METHODS Between December 2007 and March 2008, a total of 21 focus groups were conducted with 53 black families (68 parents and 57 adolescents) in Pennsylvania. Separate groups were held for males and females, and for parents and adolescents. The discussion guide explored family communication about sexual health topics, including contraception, family planning and abortion. Sessions were audio-recorded; data were transcribed and analyzed using a grounded theory approach to content analysis and the constant comparison method. RESULTS Five key themes emerged among both parents and adolescents. First, discussions about contraception were indirect and framed in terms of the need to avoid negative consequences of sex. Second, contraceptive knowledge was low. Third, parents more often reported helping male adolescents get condoms than helping females get contraceptives. Fourth, discussions emphasized planning for the future over contraception. Finally, negative attitudes toward abortion were prevalent. CONCLUSIONS Parent-adolescent communication interventions should improve contraceptive knowledge, help parents understand the harmful effects of gender biases in information dissemination, and provide mothers and fathers with communication skills tailored to enhance the role they play in their adolescents’ sexual development. PMID:20887285
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
Chamie, M; Eisman, S; Forrest, J D; Orr, M T; Torres, A
Reports on a survey of family planning clinic and community characteristics in selected US counties where high and low proportions of adolescents obtain family planning services in clinics. In areas where large proportions of teenagers are served, clinics are more numerous, flexible, diverse, innovative, assertive and visible, have larger adolescent caseloads and provide more hours of service, have more varied funding and include more types of agencies. Parental consent or notification is less likely to be required, and other types of health services are more likely to be provided. Higher proportions of continuing adolescent clients, no charge for services, lack of formal appointments, and special outreach and follow-up programs and recruitment activities, are other characteristics of clinics in these areas. They also engender more support and more opposition. In areas where relatively small proportions of teenagers visit clinics, private physicians are less likely to prescribe contraceptives to minors on their own consent, pharmacists are less likely to display contraceptives openly, state laws and policies are more often silent or ambiguous about teenagers' rights and less often encourage teaching birth control in the schools.
Ferguson, Genevieve; Abi-Jaoude, Alexxa; Johnson, Andrew; Saikaly, Riley; Woldemichael, Bethel; Maharaj, Asha; Soklaridis, Sophie; Nirula, Latika; Hasan, Mahreen; Wiljer, David
With 40 to 65% of mental health patients being cared for by family members, nearly 500,000 Canadians are serving as caregivers. Yet family members are often excluded from daily clinical interactions and the development of mental health continuing medical education (CME). This qualitative study aimed to understand how best to involve families in mental health CME and how to advance their meaningful and equitable engagement in such initiatives. Semi-structured interviews were conducted with two samples: mental health care providers (n = 8) and family members of individuals diagnosed with a co-occurring addiction and mental health problems (n = 12) to explore barriers, facilitators, and strategies for family engagement. Several themes related to the perception of expertise emerged from the interviews, including the tension between the validity of knowledge based on education/credentials and knowledge based on lived experience, as well as expressions of "voice." Participants also identified barriers to, and ethical considerations related to, family engagement, including stigma and confidentiality, and recommended strategies and supports to meaningfully include the family perspective within mental health CME. Aligning with the movement to improve collaboration between mental health professionals and service users requires developing relationships with family members. Identifying strategies to involve families in the development of CME is crucial to initiating and maintaining family engagement.
The current study examined whether there are differences between gay father families (n = 36) and heterosexual families (n = 36) on father-child relationship, fathers' experiences of parental stress and children's wellbeing. The gay fathers in this study all became parents while in same-sex
...." The Mexico City policy denies U.S. funds to foreign nongovernmental organizations (NGOs) that perform or promote abortion as a method of family planning -- even if the activities are undertaken with non-U.S. funds...
Changing Face of Family Planning Funding in Kenya: A Cross-Sectional Survey of Two Urban Counties. Nelson Keyonzo, Julius Korir, Faith Abilla, Morine Sirera, Peter Nyakwara, Eva Bazant, Charles Waka, Nancy Koskei, Mark Kabue ...
Difference between the meaning of approval and encouragement should be explored. Interventions involving information education and communication campaigns geared to men and promoting male involvement in family planning could increase contraceptive prevalence. Keywords: Contraception, male involvement, ...
What do Family Planning Clients and University Students in Nairobi, Kenya, Know and Think about Emergency Contraception? Esther Muia, Charlotte Ellertson, Shelley Clark, Moses Lukhando, Batya Elul, Joyce Olenja, Elizabeth Westley ...
Potential for Revitalisation of the Diaphragm for Family Planning in Uganda: A Rapid Assessment of the Feasibility of Introducing the SILCS Diaphragm. IT Kyamwanga, E Turyakira, M Kilbourne-Brook, PS Coffey ...
This brief article summarizes a speech given by the Director of Population Studies in Hebei, China, on family planning and sustainable development. Concurrent with the implementation of the family planning policy over the past 20 years was the implementation of development policies in rural areas. Agricultural policy shifted from support of the commune system to a land-leasing system. The land-leasing system is an improvement that inspires farmers to become wealthy and modernized. The new rural administration encourages modernization that releases manpower, and thus, frees farmers to concentrate on improving production and farming techniques rather than on increasing reproduction. Farmers decide on working time allocation and investment. Surplus agricultural laborers are migrating to cities in search of better work opportunities. Legal measures are needed to help migrants adapt to development. Urban living requires a one-child policy, while a two-child policy is acceptable in poor and mountainous rural areas. "The education of family planning must be mandatory." Under the new policies, people must become committed to family planning. Farmers are beginning to discover the benefits of family planning. Farmer's enlightenment occurred as a result of the family planning and poverty alleviation efforts during the late 1980s and 1990s. Farmers appreciate the government assistance and now believe that family planning benefits individuals and enhances their honor and responsibility. The benefits of the policy will continue into the future. "Sustainable population development is an important part of economic development." China is entering the new century with a new type of demographic structure, a new cultural system of family planning, and practical efforts.
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...
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.
The desire to control fertility has probably always been present to some degree. Even in prehistoric times, it was undoubtedly necessary to restrain fertility to improve chances of survival. Among the signs of a growing acceptance of the concept of family planning in Africa are the increasing proportions of women over 40 who are shown in surveys not to want more children, the fact that urban family planning centers have significant numbers of clients, and the large numbers of illegal abortions especially among young girls. Although contraceptive usage is increasing in many countries, large numbers of women who wish to avoid pregnancy do not use a method. Results of the 1983 National Fertility Survey demonstrated that a large proportion of women had no intention of using contraception in the future regardless of their fertility preferences. Among apparent obstacles to the success of family planning programs is the perception that they are foreign customs imposed by other cultures. Obstacles related to political and administrative will may hinder development of programs. Some health facilities do not care to offer family planning services, and some lack the needed infrastructure to do so. The persistence of high mortality, family opposition, lack of confidence in health workers with large families who advise others to limit themselves to four, and the dissuasive effect of rumors and misinformation are other factors. To increase acceptance of family planning, it is advised that the endogenous character of family planning activities be stressed, with the latent or implicit needs of the population as the starting point. Family planning information should be made more readily available, and not limited to fertile aged women.
Guiahi, Maryam; Hoover, Jennifer; Swartz, Maryke; Teal, Stephanie
Catholic hospitals operate under the Ethical and Religious Directives for Catholic Health Care Services, which for obstetrics and gynecology residents may create barriers to receiving adequate training in family planning. We evaluated how training at a Catholic hospital affects trainees' subsequent provision of reproductive health services at secular institutions. This qualitative study used semistructured interviews with recent obstetrics and gynecology graduates in generalist practice at secular institutions. We queried about their training experiences, perceived deficiencies, and current provision of family planning services. Three researchers independently coded transcripts, using grounded theory. We reached thematic saturation after 15 of 31 graduates (48%) from 7 Catholic hospital residencies participated in interviews between June 2014 and February 2015. Many participants reported a lack of awareness regarding limitations on this aspect of their training. All participants reported reproductive health care training deficiencies, and many explained that "elective" training required resident initiative to obtain. After graduation, participants reported dissatisfaction with training in family planning, delayed competency in this area, and a lack of ability to provide certain family planning procedures. All felt that Catholic programs should improve family planning training by providing routine, opt-out family planning opportunities. Obstetricians and gynecologists who trained at Catholic institutions felt that religion-based policies negatively affected their training experiences and the range of reproductive health services they subsequently provide in practice. Forming collaborations with off-site facilities, particularly for postpartum tubal ligation and uterine evacuation, may improve the reproductive care these physicians ultimately provide to women.
This article presents the result of a study conducted by Miriam N. Jato on the impact of multimedia family planning communication campaigns on contraceptive use. The study was conducted in Tanzania, where a government program integrated family planning into maternal and child health care services in 1988, while in 1992 a private-sector condom-marketing program begun and a national population policy for wider distribution of family planning information was adopted by the government. In less than 3 years, contraceptive use was found to have doubled to a level of 11.3% and the total fertility rate declined from an average of 6.3 to 5.8 live births. The result of the study indicates that exposure to media sources of family planning messages was directly associated with increased contraceptive use. Moreover, the use of modern methods increased among women who were exposed to a greater number of media sources, as did discussion of family planning with spouses and attendance of health facilities. The programmatic implications of the results confirm that utilization of multiple media channels in the promotion of family planning and other reproductive issues must be continued, with emphasis on media sources that reach large audiences.
Muhammed S. A. Masood
Full Text Available Background. The Yemeni government is focusing more attention on the needs of youth to ensure a healthy transition to adulthood. This is critical because adolescent population (ages 15–24 of 3.35 million will double in just 20 years. Young adults often lack basic knowledge about reproductive health and family planning. Objectives. To determine reproductive health and family planning knowledge and attitude among young adults aged 15 to 25+ years. Method. Sample study was taken from Marie Stopes International in Yemen which was conducted from March to July 2013 on the reproductive health age 15–49 years. Descriptive, bivariate, and multivariate analyses were employed. Results. Majority had heard about reproductive health and family planning and encouraged its methods. Television, relatives, and radio were major sources of information. Adults with higher education tend to have more awareness about health services. Knowledge about health services and family planning methods among older adults was significant, and adults in Belqees Club were more likely to have high empowerment scores for family planning methods. Conclusion. The level of knowledge about health services for reproductive health and family planning and its methods was low to moderate. The introduction of contraceptives remains a challenge in Yemen because the educational reproductive health is weak in Yemeni schools or health institutes or universities. Information about reproductive health and family planning should be provided to adolescents through medical schools curricula.
Context: Family planning is an integral part of maternal health as its uptake is a significant factor in the reduction of maternal mortality and in ensuring positive child health outcomes. Objectives: To describe prevalence and pattern of contraceptive use, and identify reasons for discontinuation among women accessing family ...
Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran, 1Department of Health Information ... perspectives of the family physicians, managers, employees and clients in the health system in. 2014. ..... Not justifying the Family Physician Plan's physicians about health problems. 29. 29. 14.5.
This paper examines the linkages between socioeconomic characteristics, attitudes, and familial contraceptive use. Past family planning programs in Nigeria have been mainly directed toward women. However, because northern Nigeria (and to a slightly lesser extent all of Nigeria) remains a patrilineal society characterized ...
Army barracks in Nigeria have low contraceptive prevalence rates (CPRs) and many children per family. The aim of this interventional study, involving 963 married women, is to determine the impact of health education on family planning knowledge, attitudes, and practices among married barrack women. The intervention ...
International Planned Parenthood Federation, London (England).
Population growth trends and family planning activities in Africa, America, Asia, Europe, and Oceania are summarized in this booklet developed by the International Planned Parenthood Federation. Narrative information for each continent gives a resume of population growth trends, reasons for the trends, population problems, policy formation, family…
Background: Family physician plan (FPP) and referral system (RS) is one of the major plans in Iran's health system with the aim of increasing the accountability in the health market, enhancing the public's access to the health services, lowering the unnecessary costs and equitable distribution of health across the society.
Sofia Cristina Iost Pavarini
Full Text Available The emotional ties and personal relationships we form during our lives affect the quality of our family relationships when we grow older. The objective of this study was to evaluate family functioning among elderly people attending adult literacy classes and to identify who they would choose to care for them in their older age. It was a descriptive and transverse study, based on the principles of the quantitative and qualitative research method. To the family functioning assessment, it was used the Family Apgar, proposed by SMILKSTEIN (1978 and data were statistically analyzed in frequency measures. 93 elderly people were evaluated. To the comprehension of caregiver choice it was made in-depth interviews with 9 participants, three of them from each Apgar category. Interviews were analyzed, following the Content Analyze Model, Thematic Analyze Category, proposed by BARDIN (1977. Ethical guidelines for research with human participants were followed. Results obtained with the Family Apgar Scale indicate that 81 participants were from well functioning families, 8 presented moderate family dysfunction and 4 presented high family dysfunction. In-depth interviews were conducted with three participants from each category. In all three groups, the caregiver of choice was the same with respect to: gender (female, family relationship (daughter and family composition (multigenerational. The definition of “Who will push my wheelchair” is a choice determined by socio-cultural values and individual life histories; the choice is a multivariate issue, affected by lifelong processes.
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.
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.
Brittain, Anna W; Williams, Jessica R; Zapata, Lauren B; Moskosky, Susan B; Weik, Tasmeen S
Family planning services are essential for reducing high rates of unintended pregnancies among young people, yet a perception that providers will not preserve confidentiality may deter youth from accessing these services. This systematic review, conducted in 2011, summarizes the evidence on the effect of assuring confidentiality in family planning services to young people on reproductive health outcomes. The review was used to inform national recommendations on providing quality family planning services. Multiple databases were searched to identify articles addressing confidentiality in family planning services to youth aged 10-24 years. Included studies were published from January 1985 through February 2011. Studies conducted outside the U.S., Canada, Europe, Australia, or New Zealand, and those that focused exclusively on HIV or sexually transmitted diseases, were excluded. The search strategy identified 19,332 articles, nine of which met the inclusion criteria. Four studies examined outcomes. Examined outcomes included use of clinical services and intention to use services. Of the four outcome studies, three found a positive association between assurance of confidentiality and at least one outcome of interest. Five studies provided information on youth perspectives and underscored the idea that young people greatly value confidentiality when receiving family planning services. This review demonstrates that there is limited research examining whether confidentiality in family planning services to young people affects reproductive health outcomes. A robust research agenda is needed, given the importance young people place on confidentiality. Published by Elsevier Inc.
Piotrow, P T; Rimon, J G
Good communication about family planning is needed for many reasons: 1) what many people think they know about family planning is wrong, 2) about 25% of the Asian population (600 million people) are between the ages of 10 and 19 and they need to be informed, 3) individuals must want to use family planning so they will use it regularly and effectively, and 4) people hear competing messages from those opposed to family planning. The authors make the following predictions for the field of family planning IEC in the 1990s: 1) family planning communication will have many different audiences, so messages and media will have to be developed for very specific groups; 2) more time will be spent on research, learning about specific audiences, the media, and background before developing messages, and messages and products will be carefully tested before being widely distributed; 3) peer groups will be used more to reach peer groups; 4) entertainment will reach and teach wider audiences about family planning, AIDS, and sexual responsibility (promoting "enter-education," a combination of entertainment and education); 5) audiences will participate more actively in different kinds of family planning communication, including community mobilization and individual involvement; 6) family planning messages will be much more personal, using human interest stories to capture and persuade the audience; 7) multiple media will be used more and more to get the message across; 8) the best quality family planning entertainment materials will be able to compete with commercial products and produce revenue; 9) campaigns and other communications will be oriented towards large regional markets; 10) more creative and more sympathetic communication in clinics and by health care providers will increase acceptance and continuation rates for many methods; 11) communication among family planning professionals will increasingly depend on effective national population information centers that can use
Bryce, C L; Siminoff, L A; Ubel, P A; Nathan, H; Caplan, A; Arnold, R M
Whether the number of organs available for transplant would be positively or negatively affected by providing benefits to families of organ donors has been debated by policymakers, ethicists and the transplant community at large. We designed a telephone survey to measure public opinion regarding the use of benefits in general and of five types in particular: funeral benefits, charitable contributions, travel/lodging expenses, direct payments and medical expenses. Of the 971 adults who completed the survey (response rate = 69%), all were from Pennsylvania households, 45.6% were registered organ donors, and 51.7% were nonwhite. Although 59% of respondents favored the general idea of incentives, support for specific incentives ranged from 53% (direct payment) to 84% (medical expenses). Among those registered as donors, more nonwhites than whites supported funeral benefits (88% vs. 81%; p = 0.038), direct payment (63% vs. 41%; p donation but would influence the behavior of others. While benefits appear to be favored, their true impact can only be assessed through pilot programs.
Feeg, Veronica D; Paraszczuk, Ann Marie; Çavuşoğlu, Hicran; Shields, Linda; Pars, Hatice; Al Mamun, Abdullah
Family-centered care (FCC) is a healthcare delivery model in which planning care for a child incorporates the entire family. The purpose of this study was to describe and compare how healthcare providers from three countries with varied cultural and healthcare systems perceive the concept FCC by measuring attitudes, and to psychometrically identify a measure that would reflect "family-centeredness." The Working with Families questionnaire, translated when appropriate, was used to capture participants' perceptions of caring for hospitalized children and their parents from pediatric healthcare providers in the United States, Australia and Turkey (n=476). The results indicated significantly more positive attitudes reported for working with children than parents for all countries and individual score differences across countries: the U.S. and Turkey child scores were significantly higher than Australia, whereas the U.S. and Australia parent scores were both significantly higher than Turkey. Perceptions of working with families were different for nurses from the three countries that call for a clearer understanding about perceptions in relation to delivery systems. Further analyses revealed FCS scores to be significantly different between nurses and physicians and significantly correlated with age, number of children and education. The results of this study add to our understanding of influences on practice from different countries and healthcare systems. The FCS score may be useful to determine baseline beliefs and ascertain effectiveness of interventions designed to improve FCC implementation. Copyright © 2016 Elsevier Inc. All rights reserved.
Indifference to family planning in Sri Lanka stems from a number of institutional factors. Family planning advocates in Sri Lanka constitute a small group of Westernized individuals who are alienated from the traditional cultural patterns of Sri Lanka society. The majority of Sri Lanka se. In traditional Sinhalese culture 1) marriages were easily dissolved; 2) fidelity was not highly valued; 3) polyandrous marriages were relatively common; 4) large families were desired; and 5) abortion and infanticide were practiced. Although the traditional culture is no longer intact, many low income Sinhalese still adhere to some elements of traditional culture and most still want to have large families. In recent years, some of the inhabitants of Sri Lanka became westernized, and most of these individuals now constitute the middle class. The middle class adopted an extremely rigid morality which they have attempted to impose on the lower class Sinhalese. The middle class tends to oppose abortion and fears that contraceptive availability will lead to promiscuous behavior. Both the middle and lower classes tend to associatefamily planning with the Tamil segment of the population. The Tamil immigrated to Sri Lanka from India, and their presence and power have always been resented and feared by theSinhalese. Many Sinhalese believe that family planning is a politically motivated attempt on the part of the Tamil to reduce the number of Sinhalese in the population. Although family planning is integrated into the government's maternal and child welfare program, resistance to family planning, especially among the lower classes, remains high. At the present time only 19% of all married women less than 50 years old practice contraception. The national family program made only a minor contribution to the recently observed decline in the fertility rate. The major factor involved in the decline was a growing pattern of delayed marriage.
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.
Yarger, Jennifer; Decker, Martha J; Campa, Mary I; Brindis, Claire D
The purpose of this study was to compare awareness and use of family planning services by rural and urban program site among a sample of adolescent women before participation in the federal Personal Responsibility Education Program in California. We conducted a secondary analysis of survey data collected from youth before participation in California's Personal Responsibility Education Program. Bivariate and multivariate analyses were conducted for a sample of 4,614 females ages 14-18 years to compare awareness and use of family planning services between participants at rural and urban program sites, controlling for the program setting and participant demographic, sexual, and reproductive characteristics. Overall, 61% of participants had heard of a family planning provider in their community, and 24% had visited a family planning provider. Awareness and use of family planning services were lower among rural participants than urban participants. After adjusting for the program setting and participant characteristics, rural participants were less likely to know about a family planning provider in their community (odds ratio, .64; 95% confidence interval, .50-.81) or receive family planning services (odds ratio, .76; 95% confidence interval, .58-.99) than urban participants. Findings suggest that adolescents in rural areas face greater barriers to accessing family planning services than adolescents in urban areas. Targeted efforts to increase awareness and use of family planning services among adolescents in rural areas and among other underserved populations are needed. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
In Nicaragua, the recently opened Regional Family Planning (FP) Center in the capital of Chontales Province provides a variety of FP services to the 60,000 citizens of Juigalpa. These services include counseling, laboratory exams, gynecologic exams, and voluntary sterilization. the Asociacion Pro Bienestar de la Familia Nicaraguense (PROFAMILIA) opened the center, since FP services have been neglected in this province as compared to access to these services in the large population centers of Managua and Leon. A recent contraceptive prevalence survey shows that contraceptive prevalence in urban areas of Nicaragua is 62%, while it is just between 13-15% in rural regions, like Chontales and Zelaya. The center will also run a community distribution program for Chontales. As of May 1993, it had 25 community distribution posts in the region, providing contraceptives and training volunteers. PROFAMILIA hopes to open another regional center in Chinandega in the western part of Nicaragua in 1993. It plans on opening a central clinic in Grenada, the third largest city, to serve 120,000 people from Grenada and the small communities surrounding Grenada.
COPE (Client-Oriented, Provider-Efficient) methodology, a self-assessment tool that has been used in 35 countries around the world, was used to improve the quality of care in family planning clinics in Kenya. COPE involves a process that legitimately invests power with providers and clinic-level staff. It gives providers more control over their…
Wunderink, S R
This study examines economic models of household choice and the role of economic factors in determining the timing of births. A static economic model is presented and tested with data from the Netherlands. After the availability of contraceptives, the family size variable shifted from being an exogenous to an endogenous one, because births could be regulated. Costs of childbearing were construed to have maintenance costs for parents and society, attendance costs of care, and intangible costs such as anxiety or personal freedom. Benefits were intangible ones, such as joy and happiness; income; public benefits; and attendance benefits. Intangible benefits enlarged the utility of children, but maintenance costs diminished resources available for consumption. Child quality was a product of market goods purchased by parents and others and household labor. Household time allocation varied with child's age. Private responsibility for children varied by country. Quality of child care varied between countries and over time. Quality was dependent upon economies of scale, variable costs by the age of the child, variable time commitments by age of the child, and market substitutes for private child care. Higher income families spent more money but less time on children. It is pointed out that Becker's model explained number of children, but not timing of births. Postponement of birth was unlikely for those with a limited education, an unpleasant job, and low wages. When the advantages and disadvantages of having a baby were positive, spouses or single women with a high subjective preference were expected to bear a child as soon as possible. Government policy can affect the average family size by increasing or decreasing the financial and/or time burden of children. Postponement may be chosen based on long term analysis of a couple's future, the formation and use of capital, and/or high subjective time preference. Before and after first birth are different frames of reference
Choi, Joyce; Chan, Sherry; Wiebe, Ellen
To assess physicians' knowledge, attitudes, and practice with respect to four evidence-based natural family planning (NFP) methods: Standard Days, cervical mucus, basal body temperature, and the lactational amenorrhea method. We undertook a cross-sectional survey of a random sample of family physicians and all gynaecologists in British Columbia (n = 460) who have women of reproductive age in their practice, as well as all affiliated residents (n = 239). Main outcome measures were (1) physicians' attitudes towards NFP and their perceptions of its effectiveness; (2) the relationship between physicians' demographic factors, their personal experience or beliefs, and their attitudes and knowledge; and (3) how these factors affect the counselling physicians offer their patients. The survey response rate was 44%. Only 3% to 6% of physicians had correct knowledge of the effectiveness in perfect use of the NFP methods cited in this study. Fifty percent of physicians who responded mention NFP to their patients as an option for contraception, and 77% of physicians mention NFP as an option to couples trying to conceive. Family physicians and residents were much more likely than gynaecologists or gynaecology residents to mention NFP during counselling. Older physicians were more likely to mention NFP than younger physicians and also had more personal experience with NFP. Most physicians in our study underestimated the effectiveness of NFP methods, and only a small proportion of physicians provide information about NFP during contraceptive counselling. Physicians need better understanding of modern methods of NFP to provide evidence-based contraceptive counselling to selected highly motivated patients who prefer NFP as a contraceptive choice.
Population growth in China will soon be out of control if measures are not taken immediately. More than 130 million children were born between 1954 and 1960; these children are now of marriage and childbearing age. Even if a couple will have only 1 child, a new baby boom is inevitable in the coming years. Under such circumstances it is important that young couples realize that late marriage and childbearing age are essential for the economic future of the motherland; 25 is being advocated as the proper age to give birth for the first time. Another problem is represented by family planning education in the countryside, where it has always been hard to implement. In some provinces family planning is combined with the responsibility system, that is, a couple, when assigned its quota of production responsibilities, signs a contract that guarantees both production and family planning. Concrete rules should be laid down for all districts within their specific conditions.
Basten, Stuart; Jiang, Quanbao
In November 2013, China announced reforms to its family planning policies whereby couples would be allowed to have a second child if either parent is an only child. The announcement garnered worldwide media coverage, and stimulated academic and popular discussion. We explore the context of the 2013 reforms, including the economic, demographic, and political motivations behind them, and speculate on their likely effect. Noting that the impact of the reforms on China's long-term demographic future is likely to be relatively slight, we consider why more radical reform may have been difficult to implement. We offer observations about possible future directions for Chinese family planning policies and explore the notion of "local pronatalism within nationally prescribed antinatalist limits" and how this suggests that an ideological shift within China's family planning apparatus may be plausible. © 2014 The Population Council, Inc.
Cuca, R; Pierce, C S
Experiments in the delivery of family planning services are an important means of testing new approaches on a relatively small scale. Over the past 20 years, extensive experimental efforts have explored such key aspects of service delivery as personnel, the use of mass media, integration of family planning with other services, intensive efforts and camps, incentive payments to acceptors, and inudation or community-based distribution. Approaches that proved successful have often been incorporated into regular programs. An examination of the methodology and findings of family planning experiments, based on a survey of 96 projects testing various approaches, highlights successes, failures, and continuing problems. The discussion of past experience halps point to criteria that might be followed in formulating future experimental projects.
Full Text Available Abstract Background With a maternal mortality ratio of 789 per 100,000 live births, and a contraceptive prevalence rate of 4.7%, South Sudan has one of the worst reproductive health situations in the world. Understanding the social norms around sexuality and reproduction, across different ethnic groups, is key to developing and implementing locally appropriate public health responses. Methods A qualitative study was conducted in the state of Western Bahr el Ghazal (WBeG in South Sudan to explore the social norms shaping decisions about family planning among the Fertit community. Data were collected through five focus group discussions and 44 semi-structured interviews conducted with purposefully selected community members and health personnel. Results Among the Fertit community, the social norm which expects people to have as many children as possible remains well established. It is, however, under competitive pressure from the existing norm which makes spacing of pregnancies socially desirable. Young Fertit women are increasingly, either covertly or overtly, making family planning decisions themselves; with resistance from some menfolk, but also support from others. The social norm of having as many children as possible is also under competitive pressure from the emerging norm that equates taking good care of one’s children with providing them with a good education. The return of peace and stability in South Sudan, and people’s aspirations for freedom and a better life, is creating opportunities for men and women to challenge and subvert existing social norms, including but not limited to those affecting reproductive health, for the better. Conclusions The sexual and reproductive health programmes in WBeG should work with and leverage existing and emerging social norms on spacing in their health promotion activities. Campaigns should focus on promoting a family ideal in which children become the object of parental investment, rather than
Hartmann, Miriam; Gilles, Kate; Shattuck, Dominick; Kerner, Brad; Guest, Greg
Research suggests that spousal communication and male involvement in decision making can positively influence family-planning use and continuation. However, few existing studies explore the dynamics of this communication and how they factor into family-planning decision making. Building upon a recent evaluation of a theory-based male-involvement intervention in Malawi, this study aimed to fill this gap by examining the role of communication in the intervention's success, through semi-structured in-depth interviews with male participants and female partners of study participants. Results support the idea that communication is an integral component of successful interventions to increase male involvement in family planning. Participants reported improvements in spousal communication, increased frequency of communication, and an increase in shared decision making as a result of the study, which directly contributed to their family-planning use. This effect was often mediated through increased knowledge or reduced male opposition to family planning. Further analysis of communication and decision-making dynamics revealed shifts in gendered communication norms, leading to improvements in spousal relationships in addition to contraceptive uptake. This study shows that interventions can and should encourage spousal communication and shared decision making, and it provides an effective model for involving men in family-planning use.
PRATA, NDOLA; FRASER, ASHLEY; HUCHKO, MEGAN J.; GIPSON, JESSICA D.; WITHERS, MELLISSA; LEWIS, SHAYNA; CIARALDI, ERICA J.; UPADHYAY, USHMA D.
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
Beeson, Tishra; Mead, Katherine H; Wood, Susan; Goldberg, Debora Goetz; Shin, Peter; Rosenbaum, Sara
The confidentiality of family planning services remains a high priority to adolescents, but barriers to implementing confidentiality and privacy practices exist in settings designed for teenagers who are medically underserved, including federally qualified health centers (FQHCs). A sample of 423 FQHCs surveyed in 2011 provided information on their use of five selected privacy and confidentiality practices, which were examined separately and combined into an index. Regression modeling was used to assess whether various state policies and organizational characteristics were associated with FQHCs' scores on the index. In-depth case studies of six FQHCs were conducted to provide additional contextual information. Among FQHCs reporting on confidentiality, most reported providing written or verbal information regarding adolescents' rights to confidential care (81%) and limiting access to family planning and medical records to protect adolescents' confidentiality (84%). Far fewer reported maintaining separate medical records for family planning (10%), using a security block on electronic medical records to prevent disclosures (43%) or using separate contact information for communications regarding family planning services (50%). Index scores were higher among FQHCs that received Title X funding than among those that did not (coefficient, 0.70) and among FQHCs with the largest patient volumes than among those with the smallest caseloads (0.43). Case studies highlighted how a lack of guidelines and providers' confusion over relevant laws present a challenge in offering confidential care to adolescents. The organizational practices used to ensure adolescent family planning confidentiality in FQHCs are varied across organizations. Copyright © 2016 by the Guttmacher Institute.
Local publications about population in Rwanda over the past 3 years have tended either to view population growth and high density as advantageous because they lead to more intensive use of resources and hence development, or to view Rwanda as regressing economically and socially because of its very rapid population growth. It is questionable whether Rwanda's development goals can be attained without bringing down the rate of population growth. Population pressure in some rural areas has become catastrophic, yet parents do not see their large families as a problem because they expect their children once grown to make their living elsewhere. Local authorities should help to communicate the concept that only demographic stability will allow achievement of communal development goals. The advantages of smaller families should be discussed. Rwanda's policy of increasing agricultural production has encountered numerous obstacles. Subdivision of plots through inheritance, sale, or sharecropping is a problem in itself and also tends to increase erosion. None of the methods of increasing plot size by collectivization or resettling the population is without serious drawbacks. The best solution appears to be encouragement of better cultivation techniques through extension agents and demonstration projects at the local level. Artisanal activities and manual labor should be promoted to provide employment at the communal level. Community development projects should be decentralized and carefully planned to meet local needs.
As part of the preparations for the 1994 UN International Conference on Population and Development, an expert group meeting on family planning (FP), health, and family well-being was held in India on October 26-30, 1992. The group focused on the following issues: 1) society and FP, a review of existing FP programs, and the implementation of FP programs (including quality of services and human resources development, unreached populations, adolescent fertility, diffusion of innovative activities, community-based distribution systems and social marketing, and future contraceptive requirements and logistics management needs); 2) FP and health (including safe motherhood and child survival, the interdependence of services, sexually transmitted diseases [STDs], and AIDS); 3) FP and family well-being (including family size, family structure, child development, fertility decline, and family support systems); and 4) the involvement of people in FP programs (community participation, cost of supplies and service, contraceptive research and development, and a reexamination of the roles of various agencies). Both developed and developing countries were considered, with an emphasis on the latter. After reviewing the progress made in implementing the World Population Plan of Action adopted in Bucharest in 1974, the expert group drafted 35 recommendations to governments, donors, and other agencies. Governments are asked to support FP programs as a cost-effective component of a development strategy, to provide opportunities for women to participate in public policy processes, to support the family through public policies and programs, to increase investments in FP and reproductive and maternal and child health, to increase support to the health and education sectors to achieve basic human rights, to provide safe access to counseling and abortion services, and to include STD/HIV education and prevention in the work of FP programs. FP programs should receive support and funding and
Full Text Available This paper explores inequalities in the use of modern family planning methods among married women of reproductive age (MWRA in rural Nepal. Data from the 2012 Nepal Household Survey (HHS were utilized, which employed a stratified, three-stage cluster design to obtain a representative sample of 9,016 households from rural Nepal. Within the sampled households, one woman of reproductive age was randomly selected to answer the survey questions related to reproductive health. Only four out of every ten rural MWRA were using a modern family planning method. Short-acting and permanent methods were most commonly used, and long-acting reversible contraceptives were the least likely to be used. Muslims were less likely to use family planning compared to other caste/ethnic groups. Usage was also lower among younger women (likely to be trying to delay or space births than older women (likely to be trying to limit their family size. Less educated women were more likely to use permanent methods and less likely to use short-term methods. To increase the CPR, which has currently stalled, and continue to reduce the TFR, Nepal needs more focused efforts to increase family planning uptake in rural areas. The significant inequalities suggest that at-risk groups need additional targeting by demand and supply side interventions.
Koehler, Gwen; And Others
CHOICES, a literacy program for homeless families, piloted a program at the Women's Emergency Shelter in Champaign, Illinois and later expanded its services to A Woman's Place, a domestic violence shelter, in Urbana, Illinois. The CHOICES program offered weekly language activities for the children and gave mothers information about developing…
Granato, Laura A,
Family systems counseling is a powerful and beneficial counseling technique that has been effective in treating families of children with learning disabilities. Family counseling has been effective in many settings, but has not been explored as a school counselor intervention. This research is a qualitative study exploring school counselorsâ experiences and perceptions while providing family counseling to families of children with learning disabilities. This counseling included a minimum...
Porter, Toni; Reiman, Kayla; Nelson, Christina; Sager, Jessica; Wagner, Janna
This article presents findings from a quasi-experimental evaluation of quality with a sample of 28 family child care providers in the All Our Kin Family Child Care Network, a staffed family child care network which offers a range of services including relationship-based intensive consultation, and 20 family child care providers who had no…
Adetoro, O O; Anate, M
An analysis of the various contraceptive methods practiced by a total of 462 student midwives from the Northern and Southern parts of Nigeria over a 3-years period is presented. The differences in age distribution, the type of contraceptive agents used, the reasons for using them, and the side effects in the two groups are statistically significant. The need to provide acceptable contraceptive advice to the rural communities by the midwives is discussed.
Gerstenblatt, Paula; Faulkner, Monica; Lee, Ahyoung; Doan, Linh Thy; Travis, Dnika
Family child care providers contend with a number of work stressors related to the dual roles of operating a small business and providing child care in their home. Research has documented many sources of work related stress for family child care providers; however, research examining family child care providers' experiences outside of the…
This study aimed at assessing the pattern of family planning methods used by antenatal patients at Federal Medical Centre, Owo, Ondo State, Nigeria. The study was conducted between December,2007 and February,2008 at the antenatal clinic of the hospital. Ethical clearance was obtained from the Ethical committee of ...
The immediate need to control the high fertility rates among women in the rural part of Nigeria has attracted the interest of scholars in the academic world. Lots have been done by international agencies and other stakeholders to encourage the use of family planning methods among women both in rural and urban areas of ...
Abstract: This study investigated factors influencing utilization of modern family planning services among women of childbearing age (15-49 years) in the University of Calabar Teaching Hospital, Calabar. Three research questions and three hypotheses were formulated. Descriptive survey design was adopted for it.
Women with unplanned pregnancy who came to the University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria, for antenatal care were studied. The aim was to establish the knowledge, attitude and practice of family planning amongst these women. The incidence of unplanned pregnancy in our antenatal population ...
Unplanned pregnancy poses a major public health challenge to women of reproductive age in Nigeria and this has been hastened by poor use of modern family planning methods. This study employed secondary data analysis of the National HIV/AIDS and Reproductive Health Survey conducted in 2007 and 2012 to ...
... implementation of family planning programmes in predominant Muslim communities was carefully appraised. This discourse therefore was written to improve the knowledge and sharpen the skill of health workers who are likely to work in such communities for effective negotiation and application of appropriate strategies.
Objective: The main objective of this study was to assess the reproductive choices for Women Living with HIV on ... planning methods can often impede family size preferences being acted upon and reproductive rights ... and long term sexual relationships, cohabiting (living as married). There were a considerable number of ...
Integration of Family Planning Services within Post Abortion Care at Health Facilities in Dessie –North East Ethiopia. ... Facility based cross - sectional study design was used including both quantitative and qualitative data collection method. The sample size was 291. The number of study units to be sampled from each ...
From September 24 through October 4,1997, a cross-sectional survey was conducted to assess the status of Community-based distribution (CBD) of family planning as perceived by reproductive age groups aged 15-49 years and the CBD workers. The study covered 14 German Agency for Technical Co-operation (GTZ) ...
Objectives: The study sought to determine factors influencing utilization of Natural Family Planning (NFP) among child bearing women in Chilonga Catchment area. The literature review was mainly obtained from studies conducted globally, regionally and Zambia inclusively. Literature review revealed that information ...
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 ... joint decisions in this regard. Keywords: Birth control, contraception, contraceptives, family planning, population control ...
AJRH Managing Editor
Nigeria. According to the 2008 Nigeria DHS only. 9.7% of married women used a modern method of contraception, while 20.2% of women had an unmet need for family planning services6. Contraceptive use was also lowest in. Northern Nigeria with 2.5% and 3.5% in the North. West and North East regions using a modern.
An intensive family planning program offering a variety of delivery systems has been successful for the last decade in the Philippines. The emphasis is on people's involvement. 2 government sponsored programs are currently spearheading a total national effort enlisting many related or complementary projects, some area specific, which utilize both private and public resources. The Commission on Population started 3 types of nonclinic based projects during 1975-76: the Total Integrated Development Approach (TIDA), the National Population/Family Planning Outreach Project (Outreach), and Project Compassion (PROCOM). Offices were set up at regional and provincial levels. The TIDA program has mostly been superseded by the Outreach program which was launched with U.S. government assistance. The PROCOM project integrates 4 social services: family planning, nutrition, food production, and environmental sanitation. At the village level, PROCOM is represented by volunteer neighborhood captains. Panay Island has the Panay Unified Services for Health (PUSH). Clinic-based delivery of maternal health services coupled with family planning services under the Population Commission are designed to reach every barangay. Rural health units are being established in every province with a population of 7-40,000. In the area covered by each rural health unit are several primary health care units with a midwife.
... 34 Education 2 2010-07-01 2010-07-01 false Individualized family service plan. 300.24 Section 300.24 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF...
Strategies to improving access and utilization to family planning methods should therefore include; the involvement of male partners as well as traditional/religious leaders, economic empowerment of women and continuous research aimed at improving safety and reduction of side effects profile of the methods among ...
In order to reverse the trends in high fertility rates, there is need to increase uptake of family planning .... reverse the stall in fertility levels, and reduce unwanted and mistimed pregnancies, levels of unsafe abortions, ..... Hosmer D, Lemeshow S. Applied Logistic Regres- sion. Second ed. New York: John Wiley & Sons; 2000.
In Malawi family planning methods used are the common modern methods. Traditional methods include breast feeding, abstinence and the wearing of a waist ring made from traditional medicine. Twenty-six indicators were reportedly used in ascertaining if a woman has conceived. Lightening of the woman's complexion ...
Sep 15, 2017 ... CNSEE. Enquête Démographique et de Santé du Congo. (EDSC-II) 2011-2012. Available at: http:// http://www.cnsee.org/pdf/EDSC2012.pdf. (Accessed: 26th August 2017). 17. Williams T, Schutt-Aine J and Cuca Y. Measuring family planning service quality through client satisfaction exit interviews. Int. Fam.
0.93-1.75]. †Pseudo R-square=0.1039, model p<0.0001. Adjusted for clinic at recruitment. * P values from likehood ratio tests. Family planning methods among women in a vaginal microbicide feasibility study in rural KwaZulu-Natal, South Africa ...
We conducted this study to find out the reasons for this low uptake in our practice environment. Methodology: This is a ... couples can space their pregnancies by at least 2 years using family planning methods, about 35% of ... is, therefore, the urgent need to find out the contraceptive prevalence in our area of practice and ...
and build upon the work non‑commercially, as long as the author is credited and the new creations are licensed under the identical terms. For reprints contact: ... Family planning has the potential to reduce maternal deaths and disabilities by delaying motherhood, spacing childbirths, avoiding unplanned pregnancy, and its.
85.8%) and prevention of unplanned or unwanted pregnancy (93.6%). With regard to perceived negative effects of family planning use, half of the respondents (50.3%) believed that it could enhance unfaithfulness among married women, 40.6%.
Context: Medical audit in healthcare has a goal to monitor and upgrade the standard of health care in a setting. Whether a client will accept, use effectively and continue to practice contraception depends on the quality of services rendered. Objective: To assess the quality of our family planning services as perceived by our ...
the way people living with HIV and AIDs in Zambia think about family planning choices and childbearing. .... it was expected that if they were not married, they would in essence be engaged in other non permanent ... who were abstaining and living a solitary life (widowed, single and divorced) (Table 1). Table 1: Type of ...
E mail: email@example.com. ABSTRACT. Aim: This study aimed at determining the awareness about family planning amongst pregnant women presenting to the antenatal clinic of Federal Medical Centre, Owo, Ondo State, Nigeria. Methodology: The study was conducted between December, 2007 and February ...
Family Planning - A Priority Social and Health Action Programme for. Africa and the Role of the Physician. Dr. A.A. Arkutu ... cern about che risk - benefit factor while ochers cite che spread of HIV infection as justification for not ... promote health and reduce che high levels of illness and mortality, especially among vulnerable.
Background: Nigeria's maternal and perinatal health status is still among the poorest in the world, with a poor contraceptive prevalence rate and a high fertility rate. Aim: The aim of this study was to assess the level of awareness of family planning methods among women attending antenatal care, its uptake, and predictors of ...
The Standard Days Method is a simple fertility awareness—based method of family planning that helps women ... Rwanda remains one of the poorest countries in ... Community health workers afﬁhatedvﬁth the sites were üained to mobilize and refer clients to clinics. Behavior change communication activities, including.
This study was designed to assess the utilization of Family planning methods and associated factors among HIV-infected women in ART clinics of public health institutions Nekemte town, East Wollega zone, Ethiopia. Facility based cross sectional study design using quantitative technique of data collection method ...
Background: Family planning in our environment had remained a delicate issue that is still reluctantly being accepted based on religious belief and the perception that it is synonymouswith population control. Objective: This study was carried out with the objectives of identifying the characteristics of contraceptive acceptors ...
AJRH Managing Editor
This health systems assessment evaluated the feasibility of introducing a new contraceptive device, the SILCS single-size diaphragm, into the existing family planning method mix in Uganda. A total of 26 focus group discussions with 201 female and. 77 male potential users and 98 key informant interviews with policymakers ...
Background: Unwanted pregnancy is a common event in our environment and many of them will end in an unsafe abortion. Unsafe abortion is a significant cause of maternal mortality. Correct use of effective family planning methods will reduce the incidence of unwanted pregnancy and improve the health of women.
Objective: To investigate family planning needs, knowledge of HIV transmission and HIV disclosure in a cohort sample that had undergone PMTCT in a resource poor setting. Design. Cross-sectional survey. Setting: Five clinics implementing PMTCT from Qaukeni Local Service Area, O.R. Tambo District in the Eastern Cape.
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, ...
Aim: This study aimed at determining the awareness about family planning amongst pregnant women presenting to the antenatal clinic of Federal Medical Centre, Owo, Ondo State, Nigeria. Methodology: The study was conducted between December, 2007 and February, 2008 at the antenatal clinic of the hospital. Ethical ...
To assess the knowledge of mothers of under- five children brought to immunisation centres of contraceptivemethods applicable bymales and their perceptions of the roles ofmales in family planning. This cross- sectional descriptive study involved a questionnaire interview of mothers who came to immunise their children at ...
Women with severe maternal morbidity represent an important group to target for increasing contraceptive uptake. Our objective was to explore the future fertility intentions, use of family planning including methods and reasons for not wanting to use contraception among a group of women who had traumatic delivery ...
A total of 2,133 currently married women age 15-49 from the 2000 survey and 1,988 ... respondent's education, knowledge of family planning, respondent's work status, ... On the other hand, number of living children, education, age and age at ...
Marfil, M P
The Sarikaya Project of the Philippine Ministry of Health's National Family Planning Office was conceived as an innovative approach to providing information, education, and communication on health, nutrition, and family planning using the services of neighborhood leaders who can gain the cooperation and participation of community members in health and family planning programs. The Sarikaya worker (SW) serves as the link between the community and the Ministry of Health. Selection of SWs is a collaborative effort of the Barangay Health Service midwife, the community, and the barangay council. SWs are trained by the BHS midwife in a 5-day seminar which includes an orientation to the role and function of the Sarikaya Project, health and family planning IEC, and 1st aid. SWs undertake activities in family planning, maternal and child health, nutrition, environmental sanitation, communicable disease control, and emergency treatment. As volunteers, the SWs receive no compensation except for a nominal training allowance. The SW relies on the BHS midwife for technical and logistical support, on the health committee of the barangay council for coordination and administrative support, and on informal community leaders for guidance and advice. Pilot testing of the sarikaya project was undertaken in 1979, when 241 workers were trained. Results of early evaluations were encouraging, and plans were made to expand the project in 1980.
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.
Piotrow, P T; Rimon, J G
Countries in Asia played a key a role in identifying problems related to population growth and high fertility and in developing strategies to address these problems. Despite the economic problems experienced by some, they continue to lead the world in designing and implementing programs in the areas of reproductive and family health using a strategic communication approach. This modern strategic communication program has the following characteristics: science and research-based, client-centered, benefit-oriented, service-linked, entertainment-education focused, professionally developed, and programmatically sustainable. This paper describes several outstanding Asian family planning communication programs in 5 countries that clearly illustrate these 7 elements. Overall, these Asian countries have shown that strategic communication can be the steering wheel for modern family planning and health promotion programs. The article concludes by giving future directions for strategic communication programs to address new emerging health and population concerns in the region.
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.
Sayin, Yazile; Aksoy, Güler
In 2008, we conducted a nonexperimental, cross-sectional, descriptive study in the surgical services department of a hospital in Istanbul, Turkey, with the aim of determining how much information was required by perioperative patients and their family members, the extent to which this information was provided, and the role that nurses play in this process. We included a total of 394 outpatients and inpatients and their family members (ie, 197 patients, 197 family members) and 30 nurses in the study. We collected the research data by using one questionnaire for patients, a second for family members of patients, and a third for nurses. We discovered that the patients and their family members wanted to be given more information about the surgical process than they had received. Patients wanted more information about the intraoperative period, whereas their family members wanted more information about the postoperative period. We also found that nurses were aware that they did not play an effective role in providing information to patients and their family members because of a lack of knowledge about what information they were responsible for providing and insufficient staffing. We concluded that nurses should know what education they are responsible for providing, put more effort into understanding patient and family member information needs, and plan a better means of providing information to meet those needs. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.
Cho, Heung-Don; Kim, Nam-Young; Gil, Hyo-wook; Jeong, Du-shin; Hong, Sae-yong
The frequency and extent of the existence of a familial suicide prevention plan may differ across cultures. The aim of this work was, therefore, to determine how common it was for families to develop a suicide prevention plan and to compare the main measures used by families with and without such a plan, after an attempt to commit suicide was made by a member of a family living in a rural area of Korea. On the basis of the presence or absence of a familial suicide prevention plan, we compared 50 recruited families that were divided into 2 groups, with Group A (31 families) employing a familial suicide prevention plan after a suicide attempt by a family member, and Group B (19 families) not doing so. The strategy that was employed most frequently to prevent a reoccurrence among both populations was promoting communication among family members, followed by seeking psychological counseling and/or psychiatric treatment. Contrary to our expectation, the economic burden from medical treatment after a suicide attempt did not influence the establishment of a familial suicide prevention plan. It is a pressing social issue that 38% (19 of 50) of families in this study did not employ a familial suicide prevention plan, even after a family member had attempted suicide. Regional suicide prevention centers and/or health authorities should pay particular attention to these patients and their families.
Pitt, Kylie; Duarte, Carlos M.; Lucas, Cathy H; Sutherland, Kelly; Condon, Robert H.; Mianzan, Hermes Walter; Purcell, Jennifer; Robinson, Kelly; Uye, Shin-Ichi
Jellyfish form spectacular blooms throughout the world?s oceans. Jellyfish body plans are characterised by high water and low carbon contents which enables them to grow much larger than non-gelatinous animals of equivalent carbon content and to deviate from non-gelatinous pelagic animals when incorporated into allometric relationships. Jellyfish have, however, been argued to conform to allometric relationships when carbon content is used as the metric for comparison. Here we test the hypothe...
Steinauer, Jody E; Turk, Jema K; Preskill, Felisa; Devaskar, Sangita; Freedman, Lori; Landy, Uta
Obstetrics and gynecology residency programs are required to provide access to abortion training, but residents can opt out of participating for religious or moral reasons. Quantitative data suggest that most residents who opt out of doing abortions participate and gain skills in other aspects of the family planning training. However, little is known about their experience and perspective. Between June 2010 and June 2011, we conducted semistructured interviews with current and former residents who opted out of some or all of the family planning training at ob-gyn residency programs affiliated with the Kenneth J. Ryan Residency Training Program in Abortion and Family Planning. Residents were either self-identified or were identified by their Ryan Program directors as having opted out of some training. The interviews were transcribed and coded using modified grounded theory. Twenty-six physicians were interviewed by telephone. Interviewees were from geographically diverse programs (35% Midwest, 31% West, 19% South/Southeast and 15% North/Northeast). We identified four dominant themes about their experience: (a) skills valued in the family planning training, (b) improved patient-centered care, (c) changes in attitudes about abortion and (d) miscommunication as a source of negative feelings. Respondents valued the ability to partially participate in the family planning training and identified specific aspects of their training which will impact future patient care. Many of the effects described in the interviews address core competencies in medical knowledge, patient care, communication and professionalism. We recommend that programs offer a spectrum of partial participation in family planning training to all residents, including residents who choose to opt out of doing some or all abortions. Learners who morally object to abortion but participate in training in family planning and abortion, up to their level of comfort, gain clinical and professional skills. We
Corroon, Meghan; Kebede, Essete; Spektor, Gean; Speizer, Ilene
The Family Planning 2020 initiative aims to reach 120 million new family planning users by 2020. Drug shops and pharmacies are important private-sector sources of contraception in many contexts but are less well understood than public-sector sources, especially in urban environments. This article explores the role that drug shops and pharmacies play in the provision of contraceptive methods in selected urban areas of Nigeria and Kenya as well as factors associated with women's choice of where to obtain these methods. Using data collected in 2010/2011 from representative samples of women in selected urban areas of Nigeria and Kenya as well as a census of pharmacies and drug shops audited in 2011, we examine the role of drug shops and pharmacies in the provision of short-acting contraceptive methods and factors associated with a women's choice of family planning source. In urban Nigeria and Kenya, drug shops and pharmacies were the major source for the family planning methods of oral contraceptive pills, emergency contraceptives, and condoms. The majority of injectable users obtained their method from public facilities in both countries, but 14% of women in Nigeria and 6% in Kenya obtained injectables from drug shops or pharmacies. Harder-to-reach populations were the most likely to choose these outlets to obtain their short-acting methods. For example, among users of these methods in Nigeria, younger women (planning users who had never been married were significantly more likely than married users to obtain these methods from a drug shop or a pharmacy than from a public-sector health facility. Low levels of family planning-related training (57% of providers in Kenya and 41% in Nigeria had received training) and lack of family planning promotional activities in pharmacies and drug shops in both countries indicate the need for additional support from family planning programs to leverage this important access point. Drug shops and pharmacies offer an important and
The most recent contraceptive prevalence survey in Colombia indicated that over 2/3 of couples at risk of conception used some contraceptive method in 1990. This figure is close to the 80% or over common in developed countries and far exceeds the rates of 10% or even less in sub-Saharan African countries. Colombia's prevalence rate of around 15% in 1965, the 1st year of institutionalized family planning programs, included many users of ineffective traditional methods. Family planning, the possibility of determining the number and spacing of children, can be analyzed from various perspectives including its legal foundation as a human right and the demographic benefits of reproductive moderation. A stable population size would substantially simplify the problems of health, education, housing, and employment faced by developing countries. From a humanitarian perspective, family planning satisfies the ancient desire of human beings to separate reproduction and sex and also opens the door to different techniques of medically assisted conception. Some of the most significant benefits of family planning are those in the area of health. The positive effects on maternal and infant health and survival of avoiding pregnancy at the extremes of the reproductive period as well as pregnancies that are too numerous or closely spaced are now recognized. Colombia's infant mortality rate has fallen from 100/1000 live births in 1965 to 24 in 1990. Many factors besides family planning were involved, and the exact contribution of higher educational levels of mothers, use of oral rehydration therapy, promotion of breastfeedings, greater availability of potable water, and vaccination programs as well as of family planning are difficult to assess. But it is clear that child survival programs that neglect to include modern contraception as a principal component are shortsighted. Infants of adolescent mothers face mortality rates that are 15-40% higher than those of mothers over 20. Beyond
Verran, Alice; Evans, Sarah; Lin, Daniel J; Griffiths, Frances
Chinese family planning policy is unique. There is limited sex education and the state is highly influential. This has resulted in extremely wide coverage of contraception with long-acting methods being favoured. The Chinese constitute a large proportion of asylum applicants to the UK. This study examines how their experiences and decisions about family planning in the UK are shaped by their cultural background. Data were drawn from 10 semi-structured qualitative interviews with female Chinese asylum seekers recruited through a family planning clinic in the UK. The increased autonomy provided by the UK system was appreciated by the participants. Choice of contraceptive method was influenced by traditional cultural beliefs and values, and the effect of hormonal contraception on menstruation was particularly concerning. Women arrived from China with little knowledge of contraception. Friends from a similar background were the most trusted source of advice. When transitioning from China to the UK unwanted pregnancies had occurred amongst unmarried women who had missed out on sex education while living in China. Chinese societal and cultural practices continue to influence family planning decisions made within the UK. Culturally competent health strategies are needed to ensure Chinese immigrant women fully benefit from family planning within the UK. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Chavane, Leonardo; Dgedge, Martinho; Bailey, Patricia; Loquiha, Osvaldo; Aerts, Marc; Temmerman, Marleen
The contraceptive prevalence rate in Mozambique was estimated as 11.3% in the last Demographic and Health Survey. The impact of family planning (FP) on women's health and on the reduction of maternal mortality is well known. Acknowledging the importance of user satisfaction in the utilisation of health services, exit interviews were used to assess women's satisfaction with FP services in Mozambique. The survey, conducted in 174 health facilities, was representative at the national level, covered all provinces, and both urban and rural areas. Overall, 86% of respondents were satisfied with FP services, but issues such as insufficient supplies of oral contraceptives and the low quality of healthcare provider/client interactions were given as reasons for women's dissatisfaction. Defined actions at the level of health service provision are needed to tackle the identified issues and ensure improved satisfaction with, and better utilisation of, FP services in Mozambique. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
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.
Meltem Demirgöz Bal; Semiha Aydın Özkan
Background: The objective of this study is to investigate the myths of women about contraceptive methods.Method: This study was planned as a cross-sectional research. The study population consisted of 1335 women aged between 16 and 56 years, who attended to a family planning clinic of a state hospital in Karaman City in the southwest part of Turkey.Findings: The mean age of women has been 32,79±8,8. While 6.2% (n=84) of the women used no contraceptive method, 70.4% (n=945) of them used an eff...
Mello, Michelle Marie; Powlowski, Marcus; Nañagas, Juan M P; Bossert, Thomas
Compared to neighboring countries, the Philippines has high fertility rates and a low prevalence of modern-method contraception use. The Philippine government faces political and cultural barriers to addressing family planning needs, but also legal barriers erected by its own policies. We conducted a review of laws and policies relating to family planning in the Philippines in order to examine how the law may facilitate or constrain service provision. The methodology consisted of three phases. First, we collected and analyzed laws and regulations relating to the delivery of family planning services. Second, we conducted a qualitative interview study. Third, we synthesized findings to formulate policy recommendations. We present a conceptual model for understanding the impact of law on public health and discuss findings in relation to the roles of health care provider regulation, drug regulation, tax law, trade policies, insurance law, and other laws on access to modern-method contraceptives.
In the past, operations research has played a significant role in providing donor agencies and family planning program managers with information to guide the development of services most likely to reduce fertility. As family planning programs have become more established, however, the focus of operations research has shifted from an emphasis solely on outcome variables such as contraceptive usage to consideration of psychosocial and quality of care variables. There is new awareness that aspects of the service delivery system itself determine client transactions (proximate psychosocial variables), which in turn affect client satisfaction and contraceptive use. Such aspects include choice of contraceptive methods, client education and counseling, providers' technical competence, client-staff relations, mechanisms to encourage continuity of use, eligibility restrictions, provider bias, and an appropriate constellation of services. Increasing emphasis is being placed on operations research to guide the process of introduction of new contraceptive technologies (e.g., Norplant) into family planning programs. Finally, there is greater appreciation of the need in operations research for nonexperimental, qualitative data collection methods such as focus group discussions, in-depth unstructured interviews, and direct observation techniques, as well as multi-level analyses that reflect the perspectives of both providers and users. As family planning programs become more complex, the disciplines of organizational psychology and sociology should be drawn upon for theoretical and methodological guidance.
Kylie A Pitt
Full Text Available Jellyfish form spectacular blooms throughout the world's oceans. Jellyfish body plans are characterised by high water and low carbon contents which enables them to grow much larger than non-gelatinous animals of equivalent carbon content and to deviate from non-gelatinous pelagic animals when incorporated into allometric relationships. Jellyfish have, however, been argued to conform to allometric relationships when carbon content is used as the metric for comparison. Here we test the hypothesis that differences in allometric relationships for several key functional parameters remain for jellyfish even after their body sizes are scaled to their carbon content. Data on carbon and nitrogen contents, rates of respiration, excretion, growth, longevity and swimming velocity of jellyfish and other pelagic animals were assembled. Allometric relationships between each variable and the equivalent spherical diameters of jellyfish and other pelagic animals were compared before and after sizes of jellyfish were standardised for their carbon content. Before standardisation, the slopes of the allometric relationships for respiration, excretion and growth were the same for jellyfish and other pelagic taxa but the intercepts differed. After standardisation, slopes and intercepts for respiration were similar but excretion rates of jellyfish were 10× slower, and growth rates 2× faster than those of other pelagic animals. Longevity of jellyfish was independent of size. The slope of the allometric relationship of swimming velocity of jellyfish differed from that of other pelagic animals but because they are larger jellyfish operate at Reynolds numbers approximately 10× greater than those of other pelagic animals of comparable carbon content. We conclude that low carbon and high water contents alone do not explain the differences in the intercepts or slopes of the allometric relationships of jellyfish and other pelagic animals and that the evolutionary longevity
Pitt, Kylie A; Duarte, Carlos M; Lucas, Cathy H; Sutherland, Kelly R; Condon, Robert H; Mianzan, Hermes; Purcell, Jennifer E; Robinson, Kelly L; Uye, Shin-Ichi
Jellyfish form spectacular blooms throughout the world's oceans. Jellyfish body plans are characterised by high water and low carbon contents which enables them to grow much larger than non-gelatinous animals of equivalent carbon content and to deviate from non-gelatinous pelagic animals when incorporated into allometric relationships. Jellyfish have, however, been argued to conform to allometric relationships when carbon content is used as the metric for comparison. Here we test the hypothesis that differences in allometric relationships for several key functional parameters remain for jellyfish even after their body sizes are scaled to their carbon content. Data on carbon and nitrogen contents, rates of respiration, excretion, growth, longevity and swimming velocity of jellyfish and other pelagic animals were assembled. Allometric relationships between each variable and the equivalent spherical diameters of jellyfish and other pelagic animals were compared before and after sizes of jellyfish were standardised for their carbon content. Before standardisation, the slopes of the allometric relationships for respiration, excretion and growth were the same for jellyfish and other pelagic taxa but the intercepts differed. After standardisation, slopes and intercepts for respiration were similar but excretion rates of jellyfish were 10× slower, and growth rates 2× faster than those of other pelagic animals. Longevity of jellyfish was independent of size. The slope of the allometric relationship of swimming velocity of jellyfish differed from that of other pelagic animals but because they are larger jellyfish operate at Reynolds numbers approximately 10× greater than those of other pelagic animals of comparable carbon content. We conclude that low carbon and high water contents alone do not explain the differences in the intercepts or slopes of the allometric relationships of jellyfish and other pelagic animals and that the evolutionary longevity of jellyfish and
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.
Meier, K J; Mcfarlane, D R
Policy theory suggests that coherent statutes--those with precise, clear goals, supported by an adequate causal theory, with clear administrative responsibilities, clear implementation rules, and assigned to committed agencies--are more likely to have their intended impact. This paper examines US family planning policies with a pooled time series analysis from 1982-88 using the Mazmanian and Sabatier policy implementation framework. Of the four family planning statutes (Title V, Title X, Title XIX, and Title XX), only Title X, the categorical grant program, meets the criteria of a coherent statute. The study reveals that a dollar spent through Title X has a much greater impact on births, abortion rates, late prenatal care, and infant neonatal mortality than does a dollar spent through other programs. The findings are strong evidence in support of designing policies with coherent statutes.
Stef Weijers; Reinder Pieters; Allan Woodburn; Hans-Heinrich Glöckner
In recent years, the transport industry has encountered numerous challenges. It experienced strong growth, but also many uncertainties. In many cases, logistics service providers were forced to change their strategy. So, the question for logistics service providers arises “how to deal best with
Tawfik, Youssef; Rahimzai, Mirwais; Ahmadzai, Malalah; Clark, Phyllis Annie; Kamgang, Evelyn
To address low contraceptive use in Afghanistan, we supported 2 large public maternity hospitals and 3 private hospitals in Kabul to use modern quality improvement (QI) methods to integrate family planning into postpartum care. In 2012, QI teams comprising hospital staff applied root cause analysis to identify barriers to integrated postpartum family planning (PPFP) services and to develop solutions for how to integrate services. Changes made to service provision to address identified barriers included creating a private counseling space near the postpartum ward, providing PPFP counseling training and job aids to staff, and involving husbands and mothers-in-law in counseling in person or via mobile phones. After 10 months, the proportion of postpartum women who received family planning counseling before discharge in the 5 hospitals increased from 36% to 55%, and the proportion of women who received family planning counseling with their husbands rose from 18% to 90%. In addition, the proportion of postpartum women who agreed to use family planning and left the hospital with their preferred method increased from 12% to 95%. Follow-up telephone surveys with a random sample of women who had received PPFP services in the 2 public hospitals and a control group of postpartum women who had received routine hospital services found significant differences in the proportion of women with self-reported pregnancies: 3% vs. 15%, respectively, 6 months after discharge; 6% vs. 22% at 12 months; and 14% vs. 35% at 18 months (P < .001). Applying QI methods helped providers recognize and overcome barriers to integration of family planning and postpartum services by testing changes they deemed feasible. PMID:25276580
Balancing career and family! Balancing what you love and who you love!! It is such an attention getting topic. And yet, if you really think about it, people have been doing it for ages. What makes it challenging in today's world is the dual income families that throw off-balance of traditional style of balancing family and profession. Balancing family and career is not as difficult. The question is more meaningful when you ask how do you find the right balance, and in fact, what is the right balance? How do you know you are there? Happiness at home and self esteem due to work is genderless issue however, it is essentially talked more in the context of women. Some of the things that could be helpful in achieving the right balance, are time management, proper prioritization, asking for help, a caring family, friends, and most importantly colleagues. In the portfolio of professional passions, it is important to identify the areas that are conducive to possibilities of changing family needs, international families, spouse's career and job relocation, etc. So, the bottom line question is whether it is possible to find a right balance between family and career? I would submit to you that with passion, courage, open- mindedness, and proper career planning, it is definitely possible. We just need to utilize the same techniques in choosing and sustaining the right balance that we use in identifying research topics and executing it. This discussion will look into further details of the challenges of balancing family and career from the perspective of also an immigrant, and possible ways of overcoming them.
Obelenienė, Birutė; Narbekovas, Andrius
The article analyses the moral difference between Natural Family Planning (NFP) and contraception. Problem Statement: Today one of the most frequently asked questions is the following: if contraception and NFP both have the same purpose of avoiding pregnancy, how can there be any moral difference between them. Moreover, people state that it does not make any difference which method is used, if the end and purpose are the same. In fact, proponents of contraceptives often argue that...
Two-thirds (67.4%) of the respondents had adequate level of knowledge on family planning services (FPS) and the most popular source of information was the radio (65.8 %). Being in a lower class (χ² =8.6; P<0.02) and attending co education schools (χ² =12.9; P< 0.001) were predictors of inadequate level of knowledge on ...
Full Text Available Irit Sinai,1,2 Susan Igras,1 Rebecka Lundgren1 1Institute for Reproductive Health, Georgetown University, Washington, DC, USA; 2Palladium, Washington, DC, USA Abstract: The standard approach for measuring unmet need for family planning calculates actual, physiological unmet need and is useful for tracking changes at the population level. We propose to supplement it with an alternate approach that relies on individual perceptions and can improve program design and implementation. The proposed approach categorizes individuals by their perceived need for family planning: real met need (current users of a modern method, perceived met need (current users of a traditional method, real no need, perceived no need (those with a physiological need for family planning who perceive no need, and perceived unmet need (those who realize they have a need but do not use a method. We tested this approach using data from Mali (n=425 and Benin (n=1080. We found that traditional method use was significantly higher in Benin than in Mali, resulting in different perceptions of unmet need in the two countries. In Mali, perceived unmet need was much higher. In Benin, perceived unmet need was low because women believed (incorrectly that they were protected from pregnancy. Perceived no need – women who believed that they could not become pregnant despite the fact that they were fecund and sexually active – was quite high in both countries. We posit that interventions that address perceptions of unmet need, in addition to physiological risk of pregnancy, will more likely be effective in changing behavior. The suggested approach for calculating unmet need supplements the standard calculations and is helpful for designing programs to better address women’s and men’s individual needs in diverse contexts. Keywords: unmet need, family planning, contraception, Mali, Benin
The government of Nangong City, a newly instituted city with a relatively large proportion of agricultural workers has integrated family planning into the building up of mental civilization. As a result, in 1986, the family planning practice rate was 98.4%. One way the government accomplished this was by developing production to eliminate poverty, to show that population development has a significant impact on socioeconomic development. To help change people's attitudes about family planning, the government 1) used publicity, such as speechmaking, mass media, and courses in population theory; 2) awarded those who made contributions; 3) carried out publicity and education in accordance with characteristics of different groups of people; and 4) encouraged bridegrooms to live with their wives' families if the wives' parents had had no son. Another technique the government used as the popularization of scientific knowledge about population theory, physiology and hygiene, birth control, and eugenics and health in births. A 4th method was to popularize knowledge of laws and regulations, such as of early marriage and consanguineous marriage. 5th, the government developed social security undertakings: 1) giving priority to single-child families and 2) taking care of the elderly. Finally, the government improved maternal and child care by 1) providing premarital health care; 2) creating a project for healthier births and better upbringing; 3) family planning workers showing warm concern for reproductive women; and 4) controlling women's diseases and providing health care knowledge, as well as family planning services. These 6 activities have resulted in 1) the decreasing momentum of per capita arable land being controlled, 2) 1-child couples having more time to learn, 3) the development of educational undertakings, 4) a change in people's traditional practices, and 5) improvement in the understanding of patriotism.
Mundigo, A I
Condoms have been used since the 16th century as a prophylactic agent against sexually transmitted diseases. With regards to family planning, condoms are used for spacing and prevention of pregnancy. However, after the invention of more reliable contraceptives, condoms lost their popularity as a contraceptive agent, only to regain it in the wake of the AIDS epidemic. The main concern in using condoms has always been the high failure rate, which tends to be a complicated issue given that it's efficacy is affected by the motivation and characteristic of the user. Irrespective of the numerous advantages of the condom, at present there is little incentive to use them on a routine basis. Reasons for this objection include the fact that condoms not only interfere with sex, but are unnatural and leave the man very unsatisfied. Promoting condoms in developing countries is both a cultural and political issue, stemming from the misleading preconception of the man's role in family planning. For instance, condoms are infamous for their use in illicit sex, and as such cannot be used on a relatively respectable individual. The challenge in condom promotion is the creation of a new image based on family planning, reliability aspects of condoms, noninterference with pleasure concept and the added value of protection against STD's.
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.
Sinai, Irit; Igras, Susan; Lundgren, Rebecka
The standard approach for measuring unmet need for family planning calculates actual, physiological unmet need and is useful for tracking changes at the population level. We propose to supplement it with an alternate approach that relies on individual perceptions and can improve program design and implementation. The proposed approach categorizes individuals by their perceived need for family planning: real met need (current users of a modern method), perceived met need (current users of a traditional method), real no need, perceived no need (those with a physiological need for family planning who perceive no need), and perceived unmet need (those who realize they have a need but do not use a method). We tested this approach using data from Mali (n=425) and Benin (n=1080). We found that traditional method use was significantly higher in Benin than in Mali, resulting in different perceptions of unmet need in the two countries. In Mali, perceived unmet need was much higher. In Benin, perceived unmet need was low because women believed (incorrectly) that they were protected from pregnancy. Perceived no need - women who believed that they could not become pregnant despite the fact that they were fecund and sexually active - was quite high in both countries. We posit that interventions that address perceptions of unmet need, in addition to physiological risk of pregnancy, will more likely be effective in changing behavior. The suggested approach for calculating unmet need supplements the standard calculations and is helpful for designing programs to better address women's and men's individual needs in diverse contexts.
This article provides an overview of some emerging research issues on population and development, appropriate program design, the impact of family planning programs, and a tentative agenda for forthcoming International Union for Scientific Study of Population (IUSSP) seminars. The 1994 Plan of Action from the International Conference on Population and Development (ICPD) in Cairo challenges the population research community. This article addresses the implications of the 1994 Plan for the IUSSP Fertility and Family Planning Committee. The Cairo ICPD policy consensus confirmed the impact of family planning programs over the decades. The conference shifted the focus to research on how family planning programs manifest this impact and who benefits. The IUSSP committee will focus on the efficiency of the investment in programs, the relevance of programs to demand-constrained economies, sustainability of programs, the appropriate design and organization of programs, and social impacts of family planning. The committee plans to hold three seminars on the aforementioned topics. The IUSSP General Conference in Beijing plans to review the literature on theories of measurement and the social impact of family planning programs. Papers at the Beijing conference will stress the impact of family planning programs on social institutions and empowerment, unmet need for contraception, and male roles. The Fertility and Family Planning Committee will discuss fertility trends and determinants in South Asia, social institutions and family planning programs in sub-Saharan Africa, and methods for evaluating family planning programs at the first committee meeting. A textbook is planned for late 1996 on methods for evaluation of family planning programs. Sub-Saharan African family planning programs must be adapted to the rapidly spreading AIDS epidemic. The Committee on AIDS will be offering an exploratory workshop on policy issues and research needs on the implications of the AIDS crisis
Two reproductive health advocacy networks have been established in two districts in eastern Africa to help promote family planning and reproductive health among the people in this area. The districts are the Suhum-Kraboa-Coaltar and the New Juaben Municipality. To enhance the performance of the network, a 4-day workshop was held at Koforidua for the members to prepare an action plan for their advocacy and map out areas of collaboration between the public and the private sector group. The workshop, organized by the Futures Group International based in the US with support from the USAID, was attended by 30 participants from nongovernmental organizations and public offices. In an address, Ms. Patience Adow, the Regional Minister observed that through the idea of family planning has been promoted in the country over the past two decades, the country continues to experience a population growth rate of about 2.8%. She expressed the hope that the workshop will equip the participants with the relevant skills to develop and implement their advocacy strategy effectively. Dr. J. E. Taylor, Medical Administrator of the Koforidua Central Hospital, who chaired the function in a bid to improve the health of women and the quality of life of the people. The Ministry of Health as part of its medium term strategic plan has developed the national reproductive health and service policy.
Kister, Joanna; And Others
This guide is designed to assist vocational home economics teachers in implementing the life planning course that is one of the six core course areas of Ohio's Work and Family Life program. Included in the guide are an introduction providing an overview of the practical problems proposed in the life planning core course area, four process modules,…
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
Saka Gunay; Ertem Meliksah; Ceylan Ali; Akdeniz Nurten
Abstract Background To describe the impact of the post-abortion family planning counseling in bringing about the contraceptive usage in women who had induced abortion in a family planning clinic. Method The Diyarbakir Office of Turkish Family Planning Association (DTFPA) is a nonprofit and nongovernmental organization which runs a family planning clinic to serve the lower socio-economic populations, in Diyarbakir-Turkey. Post abortion counseling is introduced by using proper communication ski...
Wang, Catharine; Sen, Ananda; Plegue, Melissa; Ruffin, Mack T.; O'Neill, Suzanne M.; Rubinstein, Wendy S.; Acheson, Louise S.
Objective This study examines the impact of Family Healthware™ on communication behaviors; specifically, communication with family members and health care providers about family health history. Methods A total of 3786 participants were enrolled in the Family Healthware™ Impact Trial (FHITr) in the United States from 2005-7. The trial employed a two-arm cluster-randomized design, with primary care practices serving as the unit of randomization. Using generalized estimating equations (GEE), analyses focused on communication behaviors at 6 month follow-up, adjusting for age, site and practice clustering. Results A significant interaction was observed between study arm and baseline communication status for the family communication outcomes (pscommunicating at baseline and those who were not. Among participants who were not communicating at baseline, intervention participants had higher odds of communicating with family members about family history risk (OR=1.24, p=0.042) and actively collecting family history information at follow-up (OR=2.67, p=0.026). Family Healthware™ did not have a significant effect on family communication among those already communicating at baseline, or on provider communication, regardless of baseline communication status. Greater communication was observed among those at increased familial risk for a greater number of diseases. Conclusion Family Healthware™ prompted more communication about family history with family members, among those who were not previously communicating. Efforts are needed to identify approaches to encourage greater sharing of family history information, particularly with health care providers. PMID:25901453
Underwood, Sandra Millon; Kelber, Sheryl
The family health history (FHH) has long been used by nurses and other health care providers in clinical practice to determine if an individual, their family members, or their future generations are at an increased risk of heritable disease development. Information gleaned from the FHH can be used to better integrate preventive strategies into the plan of care. This report presents a summary of an exploratory pilot study that focused on the collection and use of FHH among a targeted group of Midwestern men and women. Findings suggest a need for efforts to further enhance the public's awareness of the importance of FHH. Copyright © 2015 Elsevier Inc. All rights reserved.
PROF. OLIVER OSUAGWA
Jun 1, 2015 ... Table 1 presents the different types of family planning available methods and the percentage usage in Nigeria. Of all the women surveyed. 85.1% are currently not on any family planning method. Table 1: Frequency of Women Currently on Family Planning. Current use by method use. Frequency.
Johnston, Elizabeth; Rasmusson, Xeno; Foyil, Barbara; Shopland, Patricia
Content analysis of 35 family members stories found that sharing individualized music enhanced memory, mood and provided interactive opportunities, where family members connected and communicated with relatives who had dementia. Technology supports a positive new role for family members, who often use MP3 players (e.g. iPods), headphones,…
Hayden, Seth Christian Walter
Service providers are increasingly recognizing the need to develop effective methods for delivering supporting services to military families during deployment. Research suggests that military families experience increased levels of stress during the cycle of deployment. Bronfenbrenner (1979) conceptualized the family operating within the context…
Professional family child care providers' work with children from birth through age five can be exemplary, particularly with regard to building stable and substantive relational ties. Such long-term engagements with client children and their families offer potential for strong partnership with families and local contexts over time. This paper…
Yapie, K H
The lack of united legal opinion has become a characteristic of Islam. The Islamic community's views on family planning are therefore diverse, ranging from those who strongly resist it to those who enthusiastically support and promote it. However, in order to smoothly introduce family planning into Indonesia, religious legal support was and remains crucial. Religion, especially Islam, is very important in the lives of Indonesian people. The need for religious support was stated explicitly in the guidelines of the First Five-Year Development Plan, as one of the considerations in carrying out the National Family Planning Program. That program, the first of its kind, was provided by the Legal Affairs Committee of Muhammadiyah in 1968. The major characteristics of the four formal religious decisions on family planning are described, followed by discussion of the current views of some ulama.
Saeedi, Nika; Samadi, Abdul Khalil
Abstract Problem 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. Approach 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. Local setting 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. Relevant changes 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. Lessons learnt 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. PMID:20428392
Boerner, Kathrin; Carr, Deborah; Moorman, Sara
The effectiveness of advance care planning (ACP) may depend on family members' understanding of patient preferences. However, we know of no studies that explore the association between family relationship dynamics and ACP. ACP includes a living will, durable power of attorney for health care (DPAHC) appointment, and discussions. We evaluated the effects of three aspects of family relations--general family functioning, support and criticism from spouse, and support and criticism from children--on both overall ACP and specific DPAHC designations. Using multinomial logistic regression models and data from a sample of 293 older adults, we estimated the effects of family relationship quality on the likelihood of completing ACP and appointing a spouse or adult child as DPAHC. Analyses controlled for demographic and health characteristics. Better overall family functioning increased the odds of ACP. Higher levels of spousal support increased the odds of holding informal discussions, whereas spousal criticism reduced the odds of naming one's spouse as DPAHC. Both criticism and emotional support from children increased the odds that a child was named as DPAHC. Family dynamics affect ACP in complex ways and should be considered when patients and their families discuss end-of-life care and make DPAHC designations.
Fehring, Richard J; Schneider, Mary; Barron, Mary Lee; Pruszynski, Jessica
To determine the influence of mutual motivation on unintended pregnancy rates of couples who used natural family planning (NFP) methods to avoid pregnancy. Using an online taught NFP method, 358 women and (their male partners) indicated "how much" and "how hard" they wished to avoid pregnancy on a scale of 0 to 10 before each menstrual cycle charted over 12 month of use. This motivation scale is used in the National Survey of Family Growth as a measure of motivation. All pregnancies were verified with an online pregnancy evaluation and urine-based pregnancy test. A combined motivation score was used in analysis. There were 28 pregnancies among the low-motivation participants (N = 60) and 16 among the high-motivation participants (N = 298). At 12 months of use, there were 75 pregnancies per 100 users for the low-motivation group and only 8 for the high-motivation group. There was an 80% greater likelihood of a pregnancy with the low-motivation group (χ = 25.5, p motivation to avoid pregnancy by both the female user of a behavioral method of family planning and her male partner is required for high efficacy. Assessing motivation of both the woman and her male partner before prescribing NFP methods is recommended.
Wang, Catharine; Sen, Ananda; Plegue, Melissa; Ruffin, Mack T; O'Neill, Suzanne M; Rubinstein, Wendy S; Acheson, Louise S
This study examines the impact of Family Healthware™ on communication behaviors; specifically, communication with family members and health care providers about family health history. A total of 3786 participants were enrolled in the Family Healthware™ Impact Trial (FHITr) in the United States from 2005-7. The trial employed a two-arm cluster-randomized design, with primary care practices serving as the unit of randomization. Using generalized estimating equations (GEE), analyses focused on communication behaviors at 6month follow-up, adjusting for age, site and practice clustering. A significant interaction was observed between study arm and baseline communication status for the family communication outcomes (p'sfamily members about family history risk (OR=1.24, p=0.042) and actively collecting family history information at follow-up (OR=2.67, p=0.026). Family Healthware™ did not have a significant effect on family communication among those already communicating at baseline, or on provider communication, regardless of baseline communication status. Greater communication was observed among those at increased familial risk for a greater number of diseases. Family Healthware™ prompted more communication about family history with family members, among those who were not previously communicating. Efforts are needed to identify approaches to encourage greater sharing of family history information, particularly with health care providers. Copyright © 2015 Elsevier Inc. All rights reserved.
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
continues to refine its family planning policies and programs, it will be critical to address community perceptions around fertility and desired family size, health worker shortages, and stock-outs, as well as to engage men and boys, improve training and mentorship of health workers to provide quality services, and clarify and enforce national policies about payment for services at the local level. PMID:26085021
In Vietnam between 1989 and 1993, the modern contraceptive prevalence rate stopped at 38%. In 1984, the government implemented economic renovation (Doi Moi). This closed agricultural cooperatives which had supported commune health centers. Health workers received either low or no wages, resulting in low morale, absenteeism, and moving to the private sector or agriculture. Most women began using the IUD because it was low cost and easy to monitor, provided long-term protection against pregnancy, and there was a limited supply of oral contraceptives (OCs) and condoms. Condom use fell from 13% in 1984 to 1.4% in 1993. More than 80% of contraceptive users used the IUD. The IUD is not appropriate for many women because of health problems: 60-70% of pregnant women and 80% of parturient women have anemia, 40-60% of women have reproductive tract infections, and sexually transmitted diseases are rising. Vietnam's Prime Minister and the Communist Party are committed to expanding the range of the contraceptive method-mix and choice. Limited method choice is especially a problem in rural areas. It increases the abortion rate. About 38% of abortions supplant modern and traditional family planning methods. Improper counseling, insufficient knowledge, and low promotion of OCs account for the low use of OCs. Inferior quality, aversion by couples, and inaccessibility in most rural areas limit condom use. Women's fear and husband's objection outweigh the government's promotion of sterilization. Providers have limited comprehensive accurate and current knowledge of contraceptives. Health service facilities are concentrated in urban and semiurban areas. The quality of care in rural areas, where there is no clean water supply, is inferior. An annual target used to forecast contraceptive needs risks contraceptive stocks expiring during storage and/or disruptions in supply of users. Consecutive actions to eliminate constraints to use of other methods, developing a community level service
el Tom, A R; Lauro, D; Farah, A A; McNamara, R; Ali Ahmed, E F
In 1980, the Department of Community Medicine of the University of Khartoum designed an operations research project to test the possibility of getting village midwives to be involved in the delivery of maternal and child health and family planning (MCH/FP) services. From 1981-1983 the project was implemented by the University of Khartoum in cooperation with the Ministry of Health. The project area covered 100 km. It encompassed a largely agrarian population of 93,000 in 90 villages north of Khartoum along the banks of the Nile. The focus was on training and supervising village midwives. Information was provided on contraceptives for birth spacing, distribution of oral contraceptives, and referral for other methods. Also provided to midwives was information for mothers on oral rehydration therapy for children with diarrhea, and distribution of oral rehydration solution packets. Nutrition education was given midwives with emphasis on breastfeeding and weaning procedures. Information was also supplied about vaccination for children under 5 years of age (in collaboration with the Sudan Expanded Program on Immunization). The project was expensive, particularly regarding incentive payments for supervisors and midwives. The project had a very good start, but when incentive payments were withdrawn, it almost collapsed. At first, what midwives could do to provide maternal and child health services was targeted, but as the project went on, there was more concern for involvement of midwives in broader rural health delivery. The project area was a conservative, Islamic one. An extension area was selected 5 hours travelling time from Khartoum in Shendi District of Nile Province. The project was begun in 60 villages of 75,000 inhabitants. The land stretched for 120 km along both banks of the Nile. In the extension area, a small fee (US$.025) was charged per cycle, half going to the midwives, and half towards the health teams' expenses. 21 health zones were created, and a health
The slow progress of family planning in Egypt is not due to the insufficiency of human and material resources. The problem lies in the distribution, management, and improvement of these resources. Research and personnel training are critical to directing efforts along the right course and towards the right objectives. The Population Council (USA), at the end of 1972, identified all findings of major significance from international research on family planning programs. Of the 322 studies, not 1 was carried out in Egypt or was based on 2ndary data from Egypt. Since 1972, though, Egyptian social and medical scientists have become actively involved in demographic themes and human reproduction. These are mainly personal iniatives, often limited by a scarcity of funds. Findings of population studies are not as transferable from 1 population to another. Also, there is a diversity of research needs. Many Muslims believe that their religion outlaws birth control. Religious objection appears the most widely shared reason for nonuse. This objection suggests a series of questions on what can be done to influence religious attitudes relating to contraception. A permanent and adequately managed institution for training in family planning and related aspects of maternal education has not been set up in Egypt. Training requirements of different levels and categories of personnel must be carefully identified. The impact of training on the quality of performance must be monitored. Training should not be limited to conventional groups of trainees. Al-Azhar's Islamic Centre for Population Studies and Research was built 5 years ago with initial aid from the United Nations Fund for Population Activities. It was an attempt to create an intellectual focus on population issues, concerning how the quality of life and Islamic standards of its quality affect each other. During the 1st 5 years, the Centre devoted itself to research activities. 44 studies were conducted.
The goals of the Malaysian Family Planning Program are not only to reduce population growth from 3% to 2% by 1985 and to bring the crude birth rate to 28.2 from 30.3, but to generally improve the health of the family, and to enhance the government's efforts to raise the per capita income. The work program is divided into the Creative Unit, the Media Unit, the Production Unit, and the Field Diffusion Unit. The objectives are to build up strong support from political, community, and opinion leaders, and to run educational campaigns aimed at motivating potential acceptors. The program also runs centers training medical and paramedical personnel. The program is combined with development programs for women, especially useful among the rural population.
Full Text Available This research aims to examine the influence of marketing mix carried out media performance social media portal on attitude towards a social marketing program,and its relationship with source credibility of the portal. This study was focused on "Generasi Berencana" Program (Generation with Plan Program, a program aimed at educating the youth on family planning The Research employed Structural Equations Modeling (SEM. Based on data from 150 respondents it can be concluded that in social marketing programs, source credibility, engagement, word of mouth have positive influence on the formation of behavior, but awareness of a program is not found to influence formation of behavior. This research also obtained findings that attitudes influence behavioral intention, but subjective norms is not positively influence the formation of behavioral intentions.
Bustamante-Forest, Rosa; Giarratano, Gloria
The shift in focus on men's reproductive health was influenced by the 1994 Cairo (ICPD) Action Plan to promote gender equality and equity, empower women, and improve family health in society. Changing and improving the way in which men are involved in reproductive health can only have a positive impact on women's, men's, and children's health. Educating and counseling men about contraceptive choices is essential if they are to be supportive of women's reproductive health. Research on new male contraceptive methods must continue if the bias of women shouldering the major responsibility for contraception is to be eliminated.
Critchlow, D T
This overview of the US birth control movement reflects on the emergence of family planning policy due to the efforts of Margaret Sanger, feminists, and the civil rights movement, the eugenics motive to limit "deviant" populations, and the population control movement, which aims to solve social and economic problems through fertility control. Population control moved through three stages: from the cause of "voluntary motherhood" to advance suffrage and women's political and social status, to the concept of "birth control" promoted by socialist feminists to help empower women and the working class, to, from 1920 on, a liberal movement for civil rights and population control. Physicians such as Dr. Robert Latou Dickinson legitimized the movement in the formation of the Committee on Maternal Health in 1925, but the movement remained divided until 1939, when Sanger's group merged with the American Birth Control League, the predecessor of the present Planned Parenthood Federation of America. A key legal decision in 1939 in the United States v. One Package amended the Comstock Act and allowed for the distribution of birth control devices by mail to physicians. Sanger, after a brief retirement, formed the International Planned Parenthood Federation and supported research into the pill. Eugenicists through the Committee on Maternal Health supported Christopher Tietze and others developing the pill. Final constitutional access to contraception based on the right to privacy was granted in Griswold v. Connecticut. The ruling in Eisenstadt v. Baird in 1972 extended this right to unmarried persons. The right to privacy was further extended in the Roe v. Wade decision in 1973 on legal abortion. The argument for improving the quality of the population remained from the formation of the Population Reference Bureau in 1929 through the 1960s. Under the leadership of Rockefeller, population control was defined as justified on a scientific and humanitarian basis. US government support
Winston, Jennifer; Calhoun, Lisa M; Corroon, Meghan; Guilkey, David; Speizer, Ilene
The 2012 London Summit on Family Planning set ambitious goals to enable 120 million more women and adolescent girls to use modern contraceptives by 2020. The Urban Reproductive Health Initiative (URHI) was a Bill & Melinda Gates Foundation funded program designed to help contribute to these goals in urban areas in India, Kenya, Nigeria, and Senegal. URHI implemented a range of country-specific demand and supply side interventions, with supply interventions generally focused on improved service quality, provider training, outreach to patients, and commodity stock management. This study uses data collected by the Measurement, Learning & Evaluation (MLE) Project to examine the effectiveness of these supply-side interventions by considering URHI's influence on the number of family planning clients at health facilities over a four-year period in Kenya, Nigeria, and Senegal. The analysis used facility audits and provider surveys. Principal-components analysis was used to create country-specific program exposure variables for health facilities. Fixed-effects regression was used to determine whether family planning uptake increased at facilities with higher exposure. Outcomes of interest were the number of new family planning acceptors and the total number of family planning clients per reproductive health care provider in the last year. Higher program component scores were associated with an increase in new family planning acceptors per provider in Kenya (β = 18, 95% CI = 7-29), Nigeria (β = 14, 95% CI = 8-20), and Senegal (β = 7, 95% CI = 3-12). Higher scores were also associated with more family planning clients per provider in Kenya (β = 31, 95% CI = 7-56) and Nigeria (β = 26, 95% CI = 15-38), but not in Senegal. Supply-side interventions have increased the number of new family planning acceptors at facilities in urban Nigeria, Kenya, and Senegal and the overall number of clients in urban Nigeria and Kenya. While tailoring
Tumlinson, Katherine; Speizer, Ilene S; Curtis, Siân L; Pence, Brian W
In the field of international family planning, quality of care as a reproductive right is widely endorsed, yet we lack validated data-collection instruments that can accurately assess quality in terms of its public health importance. This study, conducted within 19 public and private facilities in Kisumu, Kenya, used the simulated client method to test the validity of three standard data-collection instruments used in large-scale facility surveys: provider interviews, client interviews, and observation of client-provider interactions. Results found low specificity and low positive predictive values in each of the three instruments for a number of quality indicators, suggesting that the quality of care provided may be overestimated by traditional methods of measurement. Revised approaches to measuring family planning service quality may be needed to ensure accurate assessment of programs and to better inform quality-improvement interventions. © 2014 The Population Council, Inc.
Family planning clinics for university students play a valuable role in promoting health. This research project, a pilot study among women students who sought family planning services through a Costa Rican university clinic, introduced student evaluation of the family planning clinic, documented services provided in family planning visits, and identified issues for further study. Aged 18-33 years, the 53 respondents (a convenient sample) who completed a self-administered questionnaire were mostly (64%) single; all were sexually active; and 78% wished to have children (or more children) some day. Though all were sexually active at the time of their visit, only 62% were currently using contraception, and fewer than half of these were using effective methods. Nearly all students (96%) reported they learned new information during their appointment, and many received screening tests and examinations. Respondents rated their satisfaction with aspects of clinic service as high, citing the clinic's low visibility on campus as the most important area for improvement. All of the students said they would definitely return (85%) or would consider returning (15%). The results support the continuance of such a clinic on the campus, as well as of the practice of student evaluation. This collaborative study demonstrated areas for future research and stimulated interest in the university clinic as a research setting.
Clemmer, Sarah J.; Ward-Griffin, Catherine; Forbes, Dorothy
Canadians are experiencing increased life expectancy and chronic illness requiring end-of-life care. There is limited research on the multiple roles for family members providing home-based palliative care. Based on a larger ethnographic study of client-family-provider relationships in home-based palliative care, this qualitative secondary analysis…
Availability of resources was checked using provider interview and inventory checklist. Moreover, a total of 150 ... Hence, it is advisable that health managers of the health facilities and the district health office ensure improved availability of trained personnel, IEC materials and other supplies at the clinics. Keywords: Family ...
Berry, L.G.; Brown, M.A.; Wright, T.; White, D.L.
The national evaluation of the Weatherization Assistance Program (WAP) consists of five separate studies. The Single-Family Study is one of three studies that will estimate program energy savings and cost effectiveness in principal WAP submarkets. This report presents the experimental plan for the Single-Family Study, which will be implemented over the next three years (1991--1993). The Single-Family Study will directly estimate energy savings for a nationally representative sample of single-family and small multifamily homes weatherized in the 1989 program year. Savings will be estimated from gas and electric utility billing records using the Princeton Scorekeeping Method (PRISM). The study will also assess nonenergy impacts (e.g., health, comfort, safety, and housing affordability), estimate cost effectiveness, and analyze factors influencing these outcomes. For homes using fuels such as wood, coal, fuel oil, kerosene, and propane as the primary source of space conditioning, energy savings will be studied indirectly. The study will assemble a large nationally representative data base. A cluster sampling approach will be used, in which about 400 subgrantees are selected in a first stage and weatherized homes are selected in a second range. To ensure that the Single-Family Study is able to identify promising opportunities for future program development, two purposively selected groups of subgrantees will be included: (1) subgrantees that install cooling measures (such as more efficient air conditioning equipment or radiant barriers), and (2) exemplary subgrantees that use state-of-the-art technologies and service delivery procedures (such as advanced audit techniques, blower door tests, infrared scanners, extensive client education, etc.). These two groups of subgrantees will be analyzed to identify the most effective program elements in specific circumstances. 14 refs., 4 figs., 3 tabs.
Hinojosa, Melanie Sberna; Fernandez-Baca, Daniel; Knapp, Caprice
Partnering between families and their children's providers is the cornerstone of family-centered care. The aims of this study are to (1) identify factors associated with family-provider partnership and (2) determine the association between partnership and other outcome measures for children with attention-deficit hyperactivity disorder (ADHD). Using data on children with ADHD from the 2007 National Survey of Children's Health (n=5,495), we utilized descriptive, bivariate, and multivariate analyses to determine the impact of partnership on multiple health outcome measures. Children with more severe ADHD, children taking medication for ADHD, female children, Latino children, and families with increased strain were all more likely to report family-provider partnerships. Family-provider partnership was associated with fewer missed school days (16% less) and more preventive care visits (11% more) among children with ADHD. Family provider partnership is an important factor in the health care of children with ADHD. This relationship, along with other factors such as family strain, health insurance, gender, and racial/ethnic differences play a large role in a family's experience of their child's ADHD diagnosis.
Anand Mohan Dixit
Full Text Available Objective: To assess the knowledge of contraceptive methods and intended family size among the men of urban slum.Material and Method: Present study conducted in urban slum area of Jaipur. Information from 400 married men of age group 18-49 years collected on semi structured schedule during June to October 2012.House to house survey conducted to achieve defined sample size. Data were analyzed by using SPSS 12 soft ware. Chi square, t test and ANOVA were used for interpretation.Result and Conclusion: Most commonly known methods of family planning were female sterilization (95.2%, condom (94.7% and Male sterilization (93.5%. IUCD (57% was still not popularly known method of contraception. Emergency contraceptive pills (12.2% and Injectables (25.7% were least known methods among men. Knowledge of different contraceptive differs according to educational status and caste of men. TV and radio were main source of information. Only 16% men said that they got information from health personnel. On analysis present family size was 3.125 while desired family size was 2.63, it shows that two child norm is not ideal to all. Men who had already two children 53 % of them still want to expand their family. Approximately half of the men feel that they have larger family size and the main reasons were inappropriate knowledge (37% and ignorance (21%. Those men who want to expand their family size, son preference was the major reason. Only 3% men show the intention of one child as ideal in family, which indicate that one child norm is too far to reach.
Gao, M; He, S; Zhang, F; Lu, C; Liao, J; Wei, L; Cheng, R
This document discusses the clash between traditional concepts about fertility in China and goals which seek to reduce fertility and promote equality between the sexes. The traditional emphasis on having a son to carry on the family line and support his elders is seen as a practical necessity by many rural dwellers. During a 6-month period starting in April 1992, therefore, "China Population News" published commentaries on this subject written by people from all walks of life and all areas of China. Six of these commentaries are presented in this article. In the first, a family planning (FP) worker notes that farmers without sons currently have an economic and social disadvantage, which may be mitigated if daughters can carry on family lines and have an equal right of inheritance. Another FP worker also urges women to affirm that they can carry on the family name. A farmer, however, believes that every man should have a son to carry on their family line because daughters become members of their husband's families upon marriage. A third FP worker finds feudal ideas of male superiority still at work in small towns and feels that education and socioeconomic development will be required to encourage farmers to abandon this outmoded concept. Another farmer then relays that her family's response to having a single daughter was to have her son-in-law become a member of her family, with the first child having her surname and the second child his. The final account is from a government worker whose only brother was killed. Despair killed her mother and almost killed her father until he understood that his daughter and son-in-law would care for him in his old age. This woman's first child was given both surnames.
Biswas, Kamal K; Pearson, Erin; Shahidullah, S M; Sultana, Sharmin; Chowdhury, Rezwana; Andersen, Kathryn L
In Bangladesh, abortion is restricted except to save the life of a woman, but menstrual regulation is allowed to induce menstruation and return to non-pregnancy after a missed period. MR services are typically provided through the Directorate General of Family Planning, while postabortion care services for incomplete abortion are provided by facilities under the Directorate General of Health Services. The bifurcated health system results in reduced quality of care, particularly for postabortion care patients whose procedures are often performed using sub-optimal uterine evacuation technology and typically do not receive postabortion contraceptive services. This study evaluated the success of a pilot project that aimed to integrate menstrual regulation, postabortion care and family planning services across six Directorate General of Health Services and Directorate General of Family Planning facilities by training providers on woman-centered abortion care and adding family planning services at sites offering postabortion care. A pre-post evaluation was conducted in the six large intervention facilities. Structured client exit interviews were administered to all uterine evacuation clients presenting in the 2-week data collection period for each facility at baseline (n = 105; December 2011-January 2012) and endline (n = 107; February-March 2013). Primary outcomes included service integration indicators such as provision of menstrual regulation, postabortion care and family planning services in both facility types, and quality of care indicators such as provision of pain management, provider communication and women's satisfaction with the services received. Outcomes were compared between baseline and endline for Directorate General of Family Planning and Directorate General of Health Services facilities, and chi-square tests and t-tests were used to test for differences between baseline and endline. At the end of the project there was an increase in menstrual
Full Text Available Background: This study intends to determine the educational needs of family health staff employed in health care centers in Tabriz, the provincial capital of east Azerbaijan, Iran in 2015. Methods: In this cross-sectional study 282 staff were enrolled, together with 22 managers, through census. The data collection tool was a researcher-designed questionnaire whose content validity were confirmed by 5 experts of health care and medical education centers. They self--evaluated their knowledge, skills and attitudes in 6 task processes including "integrated care for pregnant women", "women’s general and reproductive health", "child health care and breastfeeding", "vaccination skills", "teenagers’ and young adults’ health", and "common diseases prevention and control". Cronbach alpha coefficients were over 0.85. Data analysis was done using SPSS version 16 and descriptive statistics (mean and standard deviation and one-sample t tests were calculated to compare the mean of scores with midpoint criteria (=3. Results: Generally family health staff self-evaluated their knowledge, skills and attitudes in all task processes in higher than midpoint criteria level, which was consistent with the opinions of the managers, however, educational needs required by personnel in some processes or sub- process including "common diseases prevention and control" ( knowledge on referring thalassemia couples for genetic testing, mental health counseling, "vaccination skills" ( intradermal vaccination skills, "teenagers’ and young adults’ health" (Self-care training and parents education, "women’s general and reproductive health" (principles of family planning counseling and less needs stated in "integrated care for pregnant mothers" (except for diagnosis and management of ectopic pregnancy, placenta previa and abruption and "child health care" as compared to criteria (All P value <0.05. In contrast to self-assessment results, in interorganization evaluations
This is a resume of a study that evaluated 3 communication campaigns carried out by the National Council of Population (CONAPO) between 1972 and 1976, and their effects on perceptions and attitudes regarding family planning. Data were collected in group sessions in Mexico City with lower middle and lower class women between 29 and 32 years of age and with a minimum of 2 children. Women remembered in great detail the 3 basic communications of CONAPO. The message of the second campaign, "The small family lives better," was remembered by the greatest number of women. The slogan of the third campaign, "Lady, the decision to get pregnant is yours," was remembered perfectly by most women but the remainder of the message was not. The visual images transmitted by television were quite clearly remembered except in the case of the third campaign. The auditory elements of the second and third campaigns were clearly understood, but the overall meaning of the first message was confused because a large number of messages used the same slogan. The general reaction towards "the small family lives better" was positive, but a minority of women were frustrated by the third message because it did not include details on how to carry out the proposed decision.
McCarraher, Donna R; Vance, Gwyneth; Gwarzo, Usman; Taylor, Douglas; Chabikuli, Otto Nzapfurundi
One strategy for meeting the contraceptive needs of HIV-positive women is to integrate family planning into HIV services. In 2008 in Cross River State, Nigeria,family planning was integrated into antiretroviral (ART) services in five local government areas. A basic family planning/HIV integration model was implemented in three of these areas, and an enhanced model in the other two. We conducted baseline interviews in 2008 and follow-up interviews 12-14 months later with 274 female ART clients aged 18-45 in 2009 across the five areas. Unmet need for contraception was high at baseline (28-35 percent). We found that modern contraceptive use rose in the enhanced and basic groups; most of the increase was in consistent condom use. Despite an increase in family planning counseling by ART providers, referrals to family planning services for noncondom methods were low. We conclude by presenting alternative strategies for family planning/HIV integration in settings where large families and low contraceptive use are normative.
Bangladesh has a population of 115 million people, and the economic growth rate of 3.7% during the 1980s was undermined by rapid population growth. The annual population growth rate was 3% in the 1960s and early 1970s, 2.5% between 1981-91 decreasing to 2.3% in 1991. The average of number of children is 4.6/woman compared with 7 in the 1960s. Infant mortality dropped from 150/1000 births in 1976 to 118/1000 in 1991. Life expectancy rose from 47 to 54 years. The 1991 Contraceptive Prevalence Survey showed that 39.9% of married women under 50 use contraceptives in 1991 vs. 18.6% in 1981. The use of modern methods increased from 10.9% in 1981 to 31.2% in 1991, while traditional methods rose from 7.7% to 8.7%. Sterilization was most prevalent in 1981. 29,000 female family planning (FP) workers were aggressively engaged in dispensing FP services in 1990. The Social Marketing Company sells pills, condoms, and oral rehydration salts through 130,000 retail outlets. The 1989 Contraceptive Prevalence Survey showed that 40% of pill and condom users obtained them from this network, and 95.4% of women knew about 4 methods of contraception. In 1990 there were 120 private organizations providing contraceptive services. Some of the components of the government FP program include field worker distribution door-to-door of injectable contraceptives (50% injectable usage rate in the Matlab project); recordkeeping activities; a satellite clinic network with access to contraceptive services; and decentralization through the Upazila (subdistrict) approach. The logistics system of FP has improved the warehousing, transportation, and management information system. Foreign aid (mainly USAID) financing of contraceptives helped avert 14.4 million births between 1974-90. The increase of contraceptive prevalence to 50% by 1997 would avert another 21.9 million births during 1991-96 (replacement fertility requires 70% prevalence.
Aiken, Abigail R A; Scott, James G
Following decades of mainstream bipartisan support, contraception has reemerged as a controversial political issue in the United States. At the same time, opposition to abortion has intensified. State legislatures across the country have enacted highly visible policies limiting access to family planning. Perhaps the most striking example occurred in 2011 in Texas, when legislators instituted unprecedented requirements on abortion providers and cut public funding for contraception by two thirds. Yet, despite popular interpretations of this phenomenon as a simple byproduct of increasing partisan divisions, little is understood about the factors underlying such policy shifts. We fit Bayesian ideal-point models to analyze correlation patterns in record-vote data in the Texas House of Representatives in the 2003 and 2011 Legislatures. Both sessions had large Republican majorities and saw the passage of restrictive abortion bills, but they differed markedly with respect to public funding for contraception. We demonstrate that variation in voting on family-planning issues cannot be fully attributed to partisanship in either session. However, the politics of abortion and contraception have converged over time, and - at least for Democrats - the correlation between constituency characteristics and voting behavior on family-planning legislation is markedly higher in 2011 than in 2003. These shifts have been partly driven by legislators from high-poverty, majority Latino districts near the US-Mexico border. Recent dramatic shifts in family-planning policy go beyond simple partisan divisions. As the politics of abortion and contraception have converged, policies that are increasingly hostile to reproductive health and that disproportionately affect low-income minority women have emerged. Recent shifts in family-planning policy restrict women's access to contraception and abortion, yet little research has examined why such shifts are occurring. This paper analyzes factors
Tumlinson, Katherine; Speizer, Ilene S.; Curtis, Sian L.; Pence, Brian W.
Despite widespread endorsement within the field of international family planning regarding the importance of quality of care as a reproductive right, the field has yet to develop validated data collection instruments to accurately assess quality in terms of its public health importance. This study, conducted among 19 higher volume public and private facilities in Kisumu, Kenya, used the simulated client method to test the validity of three standard data collection instruments included in large-scale facility surveys: provider interviews, client interviews, and observation of client-provider interactions. Results found low specificity and positive predictive values in each of the three instruments for a number of quality indicators, suggesting that quality of care may be overestimated by traditional methods. Revised approaches to measuring family planning service quality may be needed to ensure accurate assessment of programs and to better inform quality improvement interventions. PMID:25469929
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.
Phillips, Beth M.; Mazzeo, Debbie; Smith, Kevin
This Self-Study Guide has been developed to support Florida Voluntary Prekindergarten Providers (VPK) who are required to complete an improvement plan process (i.e., low-performing providers). The guide has sections that can be used during both the process of selecting target areas for an improvement plan and the process of implementing new or…
Kennedy, Elissa; Gray, Natalie; Azzopardi, Peter; Creati, Mick
Adolescent pregnancy has significant health and socio-economic consequences for women, their families and communities. Efforts to prevent too-early pregnancy rely on accurate information about adolescents' knowledge, behaviours and access to family planning, however available data are limited in some settings. Demographic and Health Survey (DHS) reports are recognised as providing nationally representative data that are accessible to policymakers and programmers. This paper reviews DHS reports for low and lower middle income countries in East Asia and the Pacific to determine what information regarding adolescent fertility and family planning is available, and summarises key findings. The most recent DHS reports were sought for the 33 low and lower middle income countries in the East Asia and Pacific region as defined by UNICEF and World Bank. Age-disaggregated data for all indicators relevant to fertility and current use, knowledge and access to family planning information and services were sought to identify accessible information. Reported data were analysed using an Excel database to determine outcomes for adolescents and compare with adult women. DHS reports were available for eleven countries: Cambodia, Indonesia, Marshall Islands, Nauru, Papua New Guinea, Philippines, Samoa, Solomon Islands, Timor-Leste, Tuvalu and Vietnam. Twenty seven of 40 relevant DHS indicators reported outcomes for adolescent women aged 15-19 years. There were limited data for unmarried adolescents. A significant proportion of women commence sexual activity and childbearing during adolescence in the context of low contraceptive prevalence and high unmet need for contraception. Adolescent women have lower use of contraception, poorer knowledge of family planning and less access to information and services than adult women. DHS reports provide useful and accessible data, however, they are limited by the failure to report data for unmarried adolescents and report age-disaggregated data
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
The Hungarian Central Statistical Office has carried out five different sample surveys in the last fifteen years for investigating more closely questions of fertility, family planning and birth control. The study summarizes the main findings. Some of these surveys applied retrospective methods to investigate fertility, family planning and birth control bahaviour of females in the past. Surveys of another type tried to reveal in perspective manner, with longitudinal observation of the couples, changes which took place in family planning and birth control ideas and practice. The main purpose of recent population policy measures was to ensure simple reproduction of the population. As a result of the measures taken in 1974 to increase the number of births the birth-rate went up significantly. This increase (30% as compared to 1973) appeared primarily for the second birth which constitutes 62% of the increment in births in 1974, 31% is accounted for by an 11% increase in the first births. The number of third births rose by 13% and their relative share remained 10%. The number of fourthand further births did not increase and their relative share decreased by 1%. Fertility data of 1974 show that the birth-rate increase was not in line with the intended aim, i.e. it was not the number of third births that increased. The net reproduction coefficient showing long-range growth of the population calculated with birth-rate of 1974, has developed favourably, it was over unity for the first time since 1958 (it was about 1.05). The birth-rate increased in 1974 in every age-group of females. The largest increase (19%) occurred for females 25-34 years old. Though it was 16% also for females under 24. According to a sample survey investigating the number of intended children by married females under 35 it did not increase as compared to data of previous surveys of similiar character. The differences is that the proportion of those who wished to have two children increased, while of
Colombia's rate of population growth of about 2%/year from 1938-51 increased to over 3% between 1951-64 before dropping again to 1.8% in 1985. The total fertility rate declined from 6.7 in 1969 to 3.2 in 1986, but the decline was not equal for all population sectors. In 1986, the total fertility rate was 4.4 in the Atlantic Coast region, 2.7 in Bogota, 2.8 in urban areas, 4.9 in rural areas, 5.4 for illiterate women, and 1.5 for women with higher educations. Knowledge of contraceptive methods is almost universal, with pills, IUDs, and female sterilization the best known. The proportion of women in union using contraception increased from 15% in rural areas and 45% in urban areas in 1969 to 53% in rural areas and 70% in urban areas in 1986. Use of female sterilization increased steadily to 19% of urban and 17% of rural women by 1985, while use of oral contraceptives declined slightly from 20% of urban and 12% of rural women in 1978 to 18% of urban and 13% of rural women in 1986. 11% of women in union used IUDs in 1986. Use of contraception increased rapidly with age of the woman, from 57% of women in union aged 20-24 to 76% aged 35-39. Rates of contraceptive usage in 1986 were 51% for illiterate women, 62% for those with primary educations, 72% for those with secondary educations, and 81% for those with higher educations. The private family planning organization PROFAMILIA is the contraceptive source for over 1/3 of family planning users, with especially high rates for IUD and sterilization users. PROFAMILIA sells over 1/2 of the pills, condoms, and vaginal methods used in the country. Pharmacies supply 30% of users, with especially high rates for pills, injectables, condoms, and vaginal methods. Around 1988, there will be an estimated 7,889,242 fertile aged women in Colombia, some 4,212,855 of them in union and 2,814,187 current users. Although PROFAMILIA is 1 of the most economical family planning programs in the world, its need for financial support will
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.…
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 ... size ,children dying less than five years old, husbands forbidding women from using family planning and lack of community leaders' involvement in family planning ...
World Health Organization, Copenhagen (Denmark). Regional Office for Europe.
A review is given of the status of family planning education at medical, nursing, and midwifery schools in seven European countries. The report is presented in 11 sections. Section one, an introduction, explains the scope of the study and defines family planning to include birth control, pregnancy and delivery, problems of adolescents, family life…
Hence, investments in family planning services in poor areas are not only important because they allow women to plan their births better, but also because they may lead to higher primary enrolment rates and thus contribute to ... Keywords: Fertility; Family Planning ; Path Analysis; District Panel; Children's Schooling; Africa ...
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.
Aragon, Melissa; Chhoa, Erica; Dayan, Riki; Kluftinger, Amy; Lohn, Zoe; Buhler, Karen
A birth plan is a document detailing a woman's preferences and expectations related to labour and delivery. Empirical research exploring the value of birth plans has shown conflicting findings about whether birth plans have a positive or negative effect on labour and delivery, suggesting a need for further study. This study aimed to understand the perspectives of women, health care providers, and support persons regarding the use of birth plans. A cross-sectional questionnaire was distributed to a convenience sample of expectant or postpartum women, health care providers, and support persons from January 2012 to March 2012 in British Columbia. In total, 122 women and 110 health care providers and support persons completed the questionnaire. Both women and their attendants viewed the birth plan as being valuable for acting as both a communication and education tool. However, the respondents noted that women may be disappointed or dissatisfied if a birth plan cannot be implemented. The most important elements of a birth plan identified included pain management, comfort measures (e.g., mobility during labour), postpartum preferences (e.g., breastfeeding), atmosphere (e.g., privacy), and birthing beliefs (e.g., cultural views). This is the first study to identify advantages and disadvantages of using a birth plan as well as the most important aspects of a birth plan from the perspectives of both women and their attendants in Canada. The findings could be applied to optimize the efficacy of birth plans in Canada and potentially internationally as well.
Kathpalia, S K
Prior to legalization of abortion, induced abortions were performed in an illegal manner and that resulted in many complications hence abortion was legalized in India in 1971 and the number of induced abortions has been gradually increasing since then. One way of preventing abortions is to provide family planning services to these abortion seekers so that same is not repeated. The study was performed to find out the acceptance of contraception after abortion. A prospective study was performed over a period of five years from 2010 to 2014. The study group included all the cases reporting for abortion. A proforma was filled in detail to find out the type of contraception being used before pregnancy and acceptance of contraception after abortion. The existing facilities were also evaluated. 1228 abortions were performed over a period of five years. 94.5% of abortions were during the first trimester. 39.9% had not used any contraceptive before, contraceptives used were natural and barrier which had high failure. The main indication for seeking abortion was failure of contraception and completion of family. 39.6% of patients accepted sterilization as a method of contraception. The existing post abortion family planning services are inadequate. Post abortion period is one which is important to prevent subsequent abortions and family planning services after abortion need to be strengthened.
Lyon, Maureen E; Garvie, Patricia A; Kao, Ellin; Briggs, Linda; He, Jianping; Malow, Robert; D'Angelo, Lawrence J; McCarter, Robert
To explore the effect of spirituality and religious beliefs on FAmily CEntered (FACE) Advance Care Planning and medication adherence among human immunodeficiency virus (HIV) positive adolescents and their surrogate decision-makers. A sample of HIV-positive adolescents (n = 40) and their surrogates, aged ≥ 21 years, (n = 40), was randomized to an active Healthy Living Control group or the FACE Advance Care Planning intervention, guided by transactional stress and coping theory. Adolescents' spirituality and their belief that HIV is a punishment from God were assessed at baseline and 3 months after the intervention, using the Functional Assessment of Chronic Illness Therapy-Spiritual Well Being Scale, Expanded, Version 4. Control adolescents increased faith and meaning/purpose more than FACE adolescents (p = .02). At baseline, more behaviorally infected adolescents (16%) believed that HIV was a punishment from God as compared with those who were infected perinatally (8%). Adolescents endorsing that HIV was a punishment scored lower on spirituality (p = .05) and adherence to Highly Active Antiretroviral Therapy (HAART) (p = .04). Surrogates were more spiritual than adolescents (p ≤ .0001). Providing family support in a friendly, facilitated environment enhanced spirituality among adolescents. Facilitated family conversations had an especially positive effect on medication adherence and spiritual beliefs among behaviorally infected adolescents. Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Choi, Yoonjoung; Fabic, Madeleine Short; Adetunji, Jacob
Expanding access to family planning (FP) is a driving aim of global and national FP efforts. The definition and measurement of access, however, remain nebulous, largely due to complexity. This article aims to bring clarity to the measurement of FP access. First, we synthesize key access elements for measurement by reviewing three well-known frameworks. We then assess the extent to which the Demographic and Health Surveys (DHS)-a widely used data source for FP programs and research-has information to measure these elements. We finally examine barriers to access by element, using the latest DHS data from four countries in sub-Saharan Africa. We discuss opportunities and limitations in the measurement of access, the importance of careful interpretation of data from population-based surveys, and recommendations for collecting and using data to better measure access. © 2016 The Population Council, Inc.
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.
Kohan, Shahnaz; Simbar, Masoumeh; Taleghani, Fariba
Women carry the primary responsibility for family planning in most parts of the world, and should be afforded the power of decision-making and control over their fertility. This study seeks to gain insight into Iranian women's perception of the meaning of empowerment in family planning. Using a qualitative study, seven focus group discussions and five individual interviews were conducted with 35 married Iranian women of reproductive age. The data were analysed using a conventional content analysis approach, in which themes and categories were explored to reveal women's experiences of empowerment in family planning. The results demonstrated four main categories: control over fertility plan, participative family planning, maintaining health and access to optimal family planning services. They viewed knowledge of family planning and autonomy of decision-making in fertility issues as essential elements for control of their fertility plan. Participants felt more empowered when joint family planning decisions were made with their partners in an atmosphere of agreement. Therefore, family planning policymakers should plan services with new approaches that focus on women's health and empowerment.
Cammock, Radilaite; Herbison, Peter; Lovell, Sarah; Priest, Patricia
The aim of the study was to identify unmet need and family planning access among indigenous Fijian or iTaukei women living in New Zealand and Fiji. A cross-sectional survey was undertaken between 2012-2013 in five major cities in New Zealand: Auckland, Hamilton, Wellington, Christchurch and Dunedin; and in three suburbs in Fiji. Women who did not want any (more) children but were not using any form of contraception were defined as having an unmet need. Access experiences involving cost and health provider interactions were assessed. Unmet need in New Zealand was 26% and similar to the unmet need found in Fiji (25%). Cost and concern over not being seen by a female provider were the most problematic access factors for women. There is a need for better monitoring and targeting of family planning services among minority Pacific groups, as the unmet need found in New Zealand was three times the national estimate overall and similar to the rate found in Fiji. Cost remains a problem among women trying to access family planning services. Gendered traditional roles in sexual and reproductive health maybe an area from which more understanding into cultural sensitivities and challenges may be achieved.
Molebatsi, Tshegofatso Queen
Introduction: Unmet need for family planning is high in most African countries including South Africa and Malawi as witnessed by high levels of teenage pregnancies, unwanted births and unsafe abortion. As such unmet need for family planning was added to the fifth Millennium Development Goal (MDG) as an indicator for tracking progress on improving maternal health. Objective: The primary objective of the study is to determine the correlates of unmet need for family planning among women of re...
Full Text Available Augustine Ankomah1, Jennifer Anyanti1, Muyiwa Oladosu21Society for Family Health, Abuja, Nigeria; 2MiraMonitor Consulting Ltd, Abuja, NigeriaBackground: This paper examines myths, misinformation, factual information, and communication about family planning and their effects on contraceptive use in Nigeria.Methods: A nationally representative sample of 20,171 respondents from two waves of a multiround survey (one in 2003 and the other in 2005, was analyzed at the bivariate level using Chi-square tests and at the multivariate level using logistic regression.Results: Key myths and misinformation about family planning having significant negative effects on contraceptive use included: “contraception makes women become promiscuous”, “it is expensive to practice family planning”, and “family planning causes cancer”. Factual information having significant positive effects on contraceptive use includes the messages that family planning methods are effective and not against religious teaching. The type of people with whom respondents discussed family planning had a significant effect on use of contraception. Respondents who discussed family planning with their spouse, friends, and health workers were more likely to use contraception than those who discussed it with religious leaders. Other significant predictors of contraceptive use were region of residence, gender, and socioeconomic status.Conclusion: Family planning programs should focus on eliminating myths and misinformation, while strengthening factual information. Contraception programs should factor in the role of significant others, particularly spouses and friends.Keywords: contraceptive use, family planning, logistic regression, misconceptions, myths
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
Morris, Sara M; King, Claire; Turner, Mary; Payne, Sheila
This study is based on people dying at home relying on the care of unpaid family carers. There is growing recognition of the central role that family carers play and the burdens that they bear, but knowledge gaps remain around how to best support them. The aim of this study is to review the literature relating to the perspectives of family carers providing support to a person dying at home. A narrative literature review was chosen to provide an overview and synthesis of findings. The following search terms were used: caregiver, carer, 'terminal care', 'supportive care', 'end of life care', 'palliative care', 'domiciliary care' AND home AND death OR dying. During April-May 2013, Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, Pubmed, Cochrane Reviews and Citation Indexes were searched. Inclusion criteria were as follows: English language, empirical studies and literature reviews, adult carers, perspectives of family carers, articles focusing on family carers providing end-of-life care in the home and those published between 2000 and 2013. A total of 28 studies were included. The overarching themes were family carers' views on the impact of the home as a setting for end-of-life care, support that made a home death possible, family carer's views on deficits and gaps in support and transformations to the social and emotional space of the home. Many studies focus on the support needs of people caring for a dying family member at home, but few studies have considered how the home space is affected. Given the increasing tendency for home deaths, greater understanding of the interplay of factors affecting family carers may help improve community services. © The Author(s) 2015.
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
Sharma, Vasundhara; Mohan, Uday; Das, Vinita; Awasthi, Shally
Understanding of family planning scenario among different societies and communities, which by and large reside in urban slum and rural areas, might prove useful in increasing family planning acceptance by them and decreasing population growth. To assess the sociodemographic determinants and KAP of family planning among urban slum and rural areas of Lucknow. Cross sectional. Bal Mahila Chikitsalaya, Aliganj, in urban and Primary Health Centre, Bakshi Ka Talaab, in rural area of Lucknow. October 2008 to April 2009. Six hundred and eightytwo postpartum women (within 42 days of delivery) who came to these health facilities for their child's vaccination were interviewed, by a preformed and pretested schedule. Maximum utilization of family methods were seen among Hindu women, women of age group 30 or more, parity four and more, educational level upto high school and above and those of higher socioeconomic class. Although overall residential area (urban or rural) of women had no influence on the practice of family planning by them and all of them were willing to adopt family planning methods in future, urban women were found to have a higher level of knowledge and attitude toward modern methods of family planning. Only 2.8% were unsure of preferred method for future use. Family planning programs which effectively promotes the use of family planning methods, so that the trend toward increase in population could be arrested is the need of hour.
Omolase, C O; Faturoti, S O; Omolase, B O
This study aimed at determining the awareness about family planning amongst pregnant women presenting to the antenatal clinic of Federal Medical Centre, Owo, Ondo State, Nigeria. The study was conducted between December, 2007 and February, 2008 at the antenatal clinic of the hospital. Ethical clearance was obtained from the Ethical Review Committee of the hospital prior to commencement of the study. The information was obtained from the respondents with the aid of a pre-tested semi-structured questionnaire which included their bio-data, awareness and the sources of awareness about family planning .Other information obtained were reasons for family planning as well as knowledge about the different methods of family planning. The information obtained with the study instrument (questionnaire) was collated and analyzed with SPSS statistical software version 12.0.1. Most respondents (89%) were aware of family planning. The majority of the respondents:42 (47.2%) received information about family planning from health workers while 21(23.6%) received the information through the media. Most of the respondents (74%) knew about condom. The level of education significantly affected the awareness about family planning with a p value of 0.017. Most respondents were aware of family planning. The media should play a more prominent role in creating awareness amongst the populace about family panning.
Akpom, C A; Akpom, K L; Mayer, S; Olesak, A
The validity of the fear that providing teen-age girls with family planning information and services will lead to promiscuity is examined. Changes in self-perception of the levels of sexual activity of unmarried, sexually active teen-age girls and changes in the frequency of sexual intercourse and number of sexual partners following attendance at a family planning clinic were evaluated among 71 teen-age girls. All 71 girls, aged between 13 and 18, had had sexual intercourse and were never married. 79% of the girls had had their 1st intercourse 1 or more years before their 1st attendance at a "rap" session. Only 21% had had 1st intercourse less than 1 year before attending. 61 of these girls later received contraceptive services at the clinic (clinic group) and their behavior was compared at follow-up with that of the 10 girls who did not attend the clinic again (non-clinic group). The mean frequency of sexual intercourse of the clinic group increased after receiving contraceptive services but did not differ significantly from the figure for the non-clinic group. 89% of the clinic group, after receipt of contraceptive services, restricted their sexual activity to 1 partner. This study calls into question the basis of some fears regarding the provision of family planning services to sexually active teen-age girls.
Joshi, L R
Family planning (FP) is one of the major components of reproductive health and its goal is to prevent unwanted pregnancies and regulate wanted pregnancies, thereby ensuring the health of mothers and children. It also aims at regulating the population in order to maintain the vital balance between development and the environment. Ideally, FP depends on the efforts of a couple where the man and woman are equally responsible and accountable. In reality, however, this is not the case. It is in this background that the present study aims at examining the nature and level of male participation in preventing unwanted pregnancies and the factors that influence male participation in FP. The data for the study was derived using mixed methods, drawing from both quantitative and qualitative approaches. The research design was cross-sectional, descriptive and observational. Despite the high level of knowledge and awareness about FP among the respondents, it was found that male participation in FP continues to remain very low. The multidimensional factors influencing their participation include education of the couple (the unadjusted odds ratio of higher education level of respondents is 2.182 and the adjusted OR is 1.972; and the unadjusted OR of higher education level of the spouse is 2.030, and the adjusted OR is 1.570), and economic condition (the unadjusted OR of higher income is 2.272 and the adjusted OR is 2.436) of family. Male participation in FP was found to be higher in rural areas (69.8 %) and among Dalits (72.5%). Other factors include social stigma and religious practice, patriarchal notions, gender roles and individual characteristics. Male participation plays a crucial role in population management, but patriarchal notions, socioculturally defined gender roles, combined with the inefficiency of the current FP programme, and biological factors contribute towards keeping male participation very low.
Koo, Helen P; Wilson, Ellen K; Minnis, Alexandra M
Resource constraints may make it challenging for family planning clinics to provide comprehensive contraceptive counseling; technological tools that help providers follow recommended practices without straining resources merit evaluation. A pilot study using a two-group, posttest-only experimental design evaluated Smart Choices, a computer-based tool designed to help providers offer more patient-centered counseling and enable patients to participate proactively in the counseling session. In two North Carolina family planning clinics, 214 women received usual counseling in March-May 2013, and 126 women used Smart Choices in May-July 2013. Exit interviews provided data for the evaluation. Multivariate Poisson and multinomial logistic regression analyses were performed to examine group differences in counseling outcomes. Three of 12 hypotheses tested were supported: Compared with controls, women in the intervention group knew more contraceptive methods (adjusted mean, 11.1 vs. 10.7); discussed more topics related to sexual health during counseling (1.2 vs. 0.9 among those reporting any discussion); and rated counseling as more patient-centered, an indication of how well they felt providers understood their family planning circumstances and ideas (3.9 vs. 3.7 on a scale of 1-4). Contrary to another hypothesis, controls were more likely than women in the intervention group to choose IUDs and implants. Computerized counseling aids like Smart Choices are in an early stage of development. Future research is warranted to develop tools that lead to more productive and individualized clinic visits and, ultimately, to more effective contraceptive use and reduced levels of unintended pregnancy. Copyright © 2017 by the Guttmacher Institute.
Garner, Pamela W.; Parker, Tameka S.
This article describes the implementation of a service-learning project, which was infused into a child development course. The project linked family child care providers, their licensing agency, and 39 preservice teachers in a joint effort to develop a parent handbook to be used by the providers in their child care businesses and to support…
Douglass, Anne; Taj, Kira; Coonan, Mary; Friedman, Donna Haig
Research Findings: Using a structured qualitative case study method, this study examined one urban school readiness initiative's efforts to identify and engage family, friend, and neighbor (FFN) care providers to promote school readiness in underserved and immigrant communities. Interviews and focus groups were conducted with 23 FFN providers, 14…
Rosenthal, Marjorie S; Crowley, Angela A; Curry, Leslie
Given the significant proportion of children in nonparental child care and the importance of early life experiences on development, interventions to improve a child care provider's ability to enhance a young child's development and behavior are essential. Such interventions require understanding of and responsiveness to the provider's self-perceived roles, responsibilities, and willingness to engage in such interventions, yet prior research is limited. The purpose of the study was to characterize licensed family child care provider perspectives as a first step toward designing effective provider-based interventions to improve children's development and behavior. We conducted a qualitative study using in-depth interviews with licensed family child care providers serving economically disadvantaged children. Interviews were audiotaped, transcribed, and synthesized into common themes using the constant comparative method of qualitative data analysis. The family child care providers described five domains related to their role in child development and behavior: (a) promotion, (b) assessment, (c) advising parents, (d) acknowledging barriers, and (e) their own skill development. The family child care providers we interviewed describe how the developmental and behavioral health of children is an important aspect of their role and identify innovative and feasible ways to enhance their skills. Understanding the self-perceived role, responsibility, and willingness of child care providers is an important foundation to designing effective interventions to achieve high-quality child care.
Crowley, Abby L. Winkler
Notes the difficulty of finding quality day care for special needs children. Discusses Project Specialcare, designed to support family child-care providers who accept such children into their programs. Describes how providers participated in Saturday sessions focused on a topic followed by open discussion and how the advice and counsel of a…
Connecticut Birth to Three System, Hartford.
This guide was developed to assist families and service providers in Connecticut with nutrition services for infants and toddlers with disabilities. Individual sections provide information about the following topics: laws and regulations related to nutrition services; eligibility for the Connecticut Birth to Three System and nutrition; nutrition…
Qureshi Asma M
Full Text Available Abstract Background To determine whether training of providers participating in franchise clinic networks is associated with increased Family Planning service use among low-income urban families in Pakistan. Methods The study uses 2001 survey data consisting of interviews with 1113 clinical and non-clinical providers working in public and private hospitals/clinics. Data analysis excludes non-clinical providers reducing sample size to 822. Variables for the analysis are divided into client volume, and training in family planning. Regression models are used to compute the association between training and service use in franchise versus private non-franchise clinics. Results In franchise clinic networks, staff are 6.5 times more likely to receive family planning training (P = 0.00 relative to private non-franchises. Service use was significantly associated with training (P = 0.00, franchise affiliation (P = 0.01, providers' years of family planning experience (P = 0.02 and the number of trained staff working at government owned clinics (P = 0.00. In this setting, nurses are significantly less likely to receive training compared to doctors (P = 0.00. Conclusions These findings suggest that franchises recruit and train various cadres of health workers and training maybe associated with increased service use through improvement in quality of services.
Lusiana Andriani Lubis
Full Text Available Communication strategy on family planning campaign is the interpretation on knowledge attitude and practice theory KAP theory that commonly used in many health campaign programs in developing countries and advance countries in the world. This theory can also be applied for other programs such as agriculture family planning commercial and society capacity building. The aims of this research are to described and analyzed communication strategy on family planning campaign by the field officer for family planning campaign and also to find out all factors that can be the obstacle on family planning program in Sumatera Utara province especially in Langkat District. The long term goal of this research is to find out the best method that can be done by the government in order to get peoples support. It can only be achieved if the program are transparant clearly stated and on the perfect target. The population of the research are the field officer for family planning campaign 10 person and also the citizen of Langkat District 10 person plus their husbandwife. All informants were being selected by purposive sampling technique. Observation interview and Focus Group Discussion were also being held in order to get best result. Several results were shown It showed that the better productive age couples receive information about family planning the use of contraception especially using injection and implant methods among productive age couples is increasing. Biggest problem in Langkat District is that many of the family planning acceptors using short therm contraception method such as pill condom and injection rather than long term contraception method such as IUD implant or vasectomytubectomy. BKKBN National Family Planning Coordinating Body in Langkat District still need to improve many aspects on doing communication strategy on family planning campaign by the field officer for family planning campaign especially in the low income productive age couples
...) on the operation of cafeteria plans. 1.125-3 Section 1.125-3 Internal Revenue INTERNAL REVENUE... operation of cafeteria plans. The following questions and answers provide guidance on the effect of the Family and Medical Leave Act (FMLA), 29 U.S.C. 2601 et seq., on the operation of cafeteria plans: Q-1...
Bouzidi, M; Jones, M
In 1970, a Dutch medical team began work in the city of El Kef in Tunisia on a project designed to bring family planning into rural areas. The project aimed to persuade the rural people to use urban health centers, but this approach failed partly because of the remoteness of the communities and their reluctance to discuss personal matters with strangers. Funded by UNFPA, a new project began to recruit and train local girls as home health visitors or aides-familiales, an approach which became the central focus of the El Kef project. The International Planned Parenthood Federation (IPPF) took over the project and expanded it to include nutrition, health care, health education, family planning, disease prevention and domestic crafts. 4 goals were fixed for the project: total vaccination coverage for children; elimination of severe malnutrition; reduction of infant mortality; and use of family planning practice by at least 1/2 the women of childbearing age. An efficient recordkeeping system enabled the project to be carefully evaluated and provides much-needed data, showing where it has achieved its aims and where new efforts should be directed. The project resulted in large numbers of women receiving ante-natal advice, child care and family planning from their local health centers. 860 pregnant women were followed up during the 3-year study period. Some 57% of pregnant women went for advice; only 15% went for postnatal care, but 50% of the women under 50 attended child welfare sessions during the study period for weight checks, nutrition advice, vaccination and treatment for minor ailments. Over the 3 years, the number of contraceptive users more than trebled, from 14% to 54%. The IUD was the most popular method. The most successful aspect of the project was the emphasis on maternal and child health, and the home visits were the most motivating feature. Vaccination became more popular. A further aspect of the project was the training in home improvement skills, like
James, Jayne; Cottle, Elita; Hodge, Reverend Debbie
To provide an in-depth exploration regarding the Registered Nurse (RN) and Healthcare Chaplains' (HCC) perspective of the role of the family support person (FSP) during family witnessed resuscitation (FWR). A phenomenological approach utilising in-depth interviews were undertaken outside of the work setting. A purposive sample of 4 RN's and 3 HCC were recruited from four sites within the United Kingdom. All interviews were tape recorded, transcribed verbatim and analysed utilising Husserl's framework. Seven key themes emerged which included assessment, managing choice, navigating the setting, on-going commentary, coming to terms with death, conflicts and support. This study has provided an insight regarding the intense clinical engagement associated with the role of the FSP and highlighted the importance of this role for family member's optimal care and support. It is vital that adequate professional development is instigated and that support mechanisms are in place for those health care professionals (HCP) undertaking this role in order to help family members through this difficult experience. Copyright © 2010 Elsevier Ltd. All rights reserved.
Notkola, V; Nieminen, M
"The article looks in detail at the population development in China since the 1950s, highlighting some dramatic changes. In the late 1950s the country was hit by widespread famine, which resulted in increased mortality and decreased fertility. Infant mortality climbed to almost 300/1,000. During the 1960s fertility began to increase again and mortality declined. From the beginning of the 1970s fertility started to decline, dropping from about six to just over two children per woman in the late 1980s. Today, fertility is thought to be below replacement level. The main reason for this fertility decline lies in the highly efficient family planning programmes implemented in China since the 1950s and particularly since the 1970s. The decline in infant mortality and the favourable socio-economic development have also been important factors in the decline in fertility. Although fertility in China is currently at a low level, the country's population is still set to grow." (SUMMARY IN ENG) excerpt
Full Text Available In South Africa, client satisfaction with the quality of health care has received minimal attention; probably due to the lack of locally developed and tested measures. Therefore, we developed and tested a 20-item attitude scale to determine satisfaction with Family Planning (FP services. The objectives of this study were to: ascertain reliability of the scale and confirm, through factor analysis, that satisfaction with the FP service was based on interpersonal and organisational dimensions. The sample comprised 199 black adult interviewees (158 women and 41 men, who had previously used or were currently using contraception, from an informal settlement in Gauteng, South Africa. Three items were removed from the scale due to unacceptable communality estimates. The reliability coefficient of 0.76 for the 17-item scale was satisfactory. The principal components analysis, with orthogonal and oblique rotations, extracted two factors; accounting for 51.8% of the variance. The highest loadings on Factor I involved an interpersonal dimension (friendly, encouraging, competent, informative and communicative. Factor II tended to focus on the organisational elements of the system, such as different methods, choice of methods, service availability and length of waiting time. It was concluded that this scale was a reliable, easily administered and scored measure of satisfaction, with underlying interpersonal and organisational dimensions.
Full Text Available Abstract Background The rapid population growth does not match with available resource in Ethiopia. Though household level family planning delivery has been put in place, the impact of such programs in densely populated rural areas was not studied. The study aims at measuring contraception and unmet need and identifying its determinants among married women. Methods A total of 5746 married women are interviewed from October to December 2009 in the Butajira Demographic Surveillance Area. Contraceptive prevalence rate and unmet need with their 95% confidence interval is measured among married women in the Butajira district. The association of background characteristics and family planning use is ascertained using crude and adjusted Odds ratio in logistic regression model. Results Current contraceptive prevalence rate among married women is 25.4% (95% CI: 24.2, 26.5. Unmet need of contraception is 52.4% of which 74.8% was attributed to spacing and the rest for limiting. Reasons for the high unmet need include commodities' insecurity, religion, and complaints related to providers, methods, diet and work load. Contraception is 2.3 (95% CI: 1.7, 3.2 times higher in urbanites compared to rural highlanders. Married women who attained primary and secondary plus level of education have about 1.3 (95% CI: 1.1, 1.6 and 2 (95% CI: 1.4, 2.9 times more risk to contraception; those with no child death are 1.3 (95% CI: 1.1, 1.5 times more likely to use contraceptives compared to counterparts. Besides, the odds of contraception is 1.3 (95% CI: 1.1, 1.6 and 1.5 (1.1, 2.0 times more likely among women whose partners completed primary and secondary plus level of education. Women discussing about contraception with partners were 2.2 (95% CI: 1.8, 2.7 times more likely to use family planning. Nevertheless, contraception was about 2.6 (95% CI: 2.1, 3.2 more likely among married women whose partners supported the use of family planning. Conclusions The local government
Full Text Available Background: Family planning has been defined in the framework of mothers and children plan as one of Primary Healthcare (PHC details. Besides quantity, the quality of services, particularly in terms of ethics, such as observing individuals’ privacy, is of great importance in offering family planning services.Objective: A preliminary study to gather information about the degree of medical ethics offered during family planning services at Tehran urban healthcare centers.Materials and Methods: A questionnaire was designed for study. In the first question regarding informed consent, 47 clients who were advised about various contraception methods were asked whether advantages and disadvantages of the contraceptive methods have been discussed by the service provider. Then a certain rank was measured for either client or method in 2007. Finally, average value of advantage and disadvantage for each method was measured. In questions about autonomy, justice and beneficence, yes/no answers have been expected and measured accordingly.Results: Health care providers have stressed more on the advantages of pills and disadvantages of tubectomy and have paid less attention to advantages of injection ampoules and disadvantages of pills in first time clients. While they have stressed more on the advantages and disadvantages of tubectomy and less attention to advantages of condom and disadvantages of vasectomy in second time clients. Clients divulged their 100% satisfaction in terms of observing turns and free charges services.Observance degree of autonomy was 64.7% and 77.3% for first time and second- time clients respectively.Conclusion: Applying the consultant’s personal viewpoint for selecting a method will breach an informed consent for first and second time clients. System has good consideration to justice and no malfeasance
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.
In March 1995, the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) and the government of Japan sponsored a 2-week international workshop on Family Planning Programmes of NGOs (nongovernmental organizations) in the SAARC Region (South Asia). The purpose of the workshop was to share experiences with family planning and reproductive health of the Matlab and the MCH-FP (maternal and child health-family planning) Extension Projects in urban and rural areas with family planning program managers from NGOs and policy and operations researchers. It also intended to examine those family planning and reproductive health projects of the NGOs in Bangladesh that fostered significant improvement of the national family planning and MCH program in Bangladesh. Participants were presented with effective family planning and MCH program design and strategies to strengthen improved management. The workshop emphasized the emerging norms of quality of care in family planning and reproductive health. NGOs initiated the concept of family planning in Bangladesh in 1953, so they are considered innovators. Accordingly, they are expected to develop designs and models for effective service delivery systems, training, management information system, IEC (information, education, and communication), community participation as well as to set social norms and values for small families. At the workshop, Bangladesh was offered as an example of how innovative NGO activities, sustained partnership between the NGOs and the government, and technical support from ICDDR,B lead to progress in family planning and MCH programs, despite the great poverty and economic stagnation. Contraceptive prevalence has increased from around 7% to almost 45% between 1977 and 1994.
Gleeson, Todd D; Hemmer, Paul A
Providing medical care to members of the military and their families remains a societal duty carried out not only by military physicians but also, and in large part, by civilian providers. As many military families are geographically dispersed, it is probable that all physicians at some point in their training or careers will care for this unique patient population. Understanding the military culture can help physicians provide the best care possible to our military families, and inclusion of military cultural competency curricula in all medical schools is a first step in advancing this understanding. The authors review the knowledge, skills, and attitudes that all health professionals should acquire to be able to care for those who serve and offer recommendations for developing these among all students and trainees.
Mosha, I.H.; Ruben, R.
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
Kimberly G. Smith, MD, MS
Full Text Available Purpose: The purpose of the current study is to explore third- year medical students’ interest in learning about family planning, exposure to family planning (contraception and abortion and perceived barriers and benefits to family planning education in their obstetrics and gynecology rotation.Method: We conducted four focus groups with 27 third-year medical students near the end of their rotation in obstetrics and gynecology.Results: Students desired education in family planning but perceived limited exposure during their rotation. Most students were aware of abortion but lacked factual information and abortion procedural skills. They felt systemic and faculty-related barriers contributed to limited exposure. Students discussed issues such as lack of time for coverage of contraception and abortion in the curricula and rotation itself. Perceived benefits of clinical instruction in family planning included increased knowledge of contraceptive management and abortion the ability to care for and relate to patients, opportunity for values clarification, and positive changes in attitudes towards family planning.Conclusions: Medical students who desire full education in family planning during their obstetrics and gynecology rotation may face barriers to obtaining that education. Given that many medical students will eventually care for reproductive-age women, greater promotion of opportunities for exposure to family planning within obstetrics and gynecology rotations is warranted.
levels of education. Awareness of family planning methods. Virtually all (99.8 percent) respondents were aware of the existence of modern contraceptives, and most ..... In Colombia,. Profamilia serves men at its women-oriented family planning clinics as well as in clinics for men only.23. This seemingly positive attitude of the ...
Zakiyah, Neily; van Asselt, Antoinette D. I.; Roijmans, Frank; Postma, Maarten J.
Background A significant number of women in low and middle income countries (L-MICs) who need any family planning, experience a lack in access to modern effective methods. This study was conducted to review potential cost effectiveness of scaling up family planning interventions in these regions
involvement in family planning decision making was poor and their patronage of family planning services was low (Afr J. Reprod Health 2010; 14: 45-52). ... women's reproductive rights and responsibilities. In Nigeria the high rate of .... estimating single proportions as described by. Armitage and Berry, and cited in ...
AJRH Managing Editor
We study how the availability and use of family planning services in African countries influences the family planning situation of households and through this the educational participation of young children. A district panel dataset is used for 441 urban and rural areas within 233 districts of 25 countries. Path analysis shows ...
van Soest, A.H.O.; Saha, U.R.
Abstract: Analyzing the effect of family planning on child survival remains an important issue but is not straightforward because of several mechanisms linking family planning, birth intervals, total fertility, and child survival. This study uses a dynamic model jointly explaining infant mortality,
Kakoko, D.; 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
Islam, M M; Hasan, A H
This paper analyses mass media exposure and its effect on family planning in Bangladesh using data from the Bangladesh Demographic and Health Survey (BDHS) 1993-94. The findings indicate that radio and television are two important mass media for disseminating family planning information in Bangladesh. However, access to them and exposure to family planning through them are still limited. Slightly more than 40% (42.1%) of respondents reported that they had heard family planning messages via radio, while 17.2% said television, 8.4% said poster and 5.4% said billboard. Respondent's place of residence, education, economic status, geographical region and number of living children appeared to be the most important variable determining mass media exposure to family planning. Multivariate analysis shows that both radio and TV exposure to family planning messages and ownership of a radio and TV have a significant effect on current use of family planning methods. These factors remain significant determinants of contraceptive use, even after controlling socioeconomic and demographic factors. The study reveals that both socioeconomic development policies and family planning programmes with a special emphasis on mass media, especially radio, may have a significant effect on contraceptive use in Bangladesh. The principal policy challenge is to design communications strategies that will reach the less privileged, rural and illiterate people who are by far the majority in Bangladesh.
Sarnquist, Clea C; Rahangdale, Lisa; Maldonado, Yvonne
Review key topics and recent literature regarding reproductive health and family planning needs for HIV-infected women in Sub-Saharan Africa. Electronic searches performed in PubMed, JSTOR, and Web of Science; identified articles reviewed for inclusion. Most HIV-infected women in Sub-Saharan Africa bear children, and access to antiretroviral therapy may increase childbearing desires and/or fertility, resulting in greater need for contraception. Most contraceptive options can be safely and effectively used by HIV-infected women. Unmet need for contraception is high in this population, with 66- 92% of women reporting not wanting another child (now or ever), but only 20-43% using contraception. During pregnancy and delivery, HIV-infected women need access to prevention of mother-to-child transmission (PMTCT) services, a skilled birth attendant, and quality post-partum care to prevent HIV infection in the infant and maximize maternal health. Providers may lack resources as well as appropriate training and support to provide such services to women with HIV. Innovations in biomedical and behavioral interventions may improve reproductive healthcare for HIV-infected women, but in Sub-Saharan Africa, models of integrating HIV and PMTCT services with family planning and reproductive health services will be important to improve reproductive outcomes. HIV-infected women in Sub-Saharan Africa have myriad needs related to reproductive health, including access to high-quality family planning information and options, high-quality pregnancy care, and trained providers. Integrated services that help prevent unintended pregnancy and optimize maternal and infant health before, during and after pregnancy will both maximize limited resources as well as provide improved reproductive outcomes.
... agencies consider in providing site planning and landscape design services? 102-76.20 Section 102-76.20... What issues must Federal agencies consider in providing site planning and landscape design services? In providing site planning and design services, Federal agencies must— (a) Make the site planning and landscape...
Mauldin, W P
) segura de traducir las estadísticas de servicio en práticas y tal vez aún datos sobre suministro comercial en datos sabre tasas de natalidad. Esto incluye, par ejemplo, los esfuerzos para consolidar observaciones coma "cinco años-mujer de usa de IUD, a 400 condones equivalen a la prevención de un nacimiento," y esfuerzos como los de Pakistán de calcular tasas coma "años de protección de una pareja contra el embarazo."In the belief that a decrease in the rate of population growth will increase economic development, more than ten countries have inaugurated family planning programs in the past fifteen years. To provide a model for measuring the immediate, intermediate, and long-term effects of any such program, the authors use the Taiwan evaluation.The model suggests that a good system of evaluation should include monthly statistics on (1) participants, who are grouped by characteristics; (2) the distribution of supplies, reported at first by the characteristics of recipients, but after by gross volume only; (3) family planning activities of private physicians to measure the catalytic effect on the private sector; (4) new contacts and amount of advertising in mass media; (5) costs broken down by areas and by cost categories; and (6) distribution of commercial supplies. In addition, the program should conduct 300-400 interviews every 6-12 months to learn the rates of continuation and the rates and reasons for discontinuation. Finally, a KAP survey should be conducted every two years.The administration of the evaluation should be close to the director for policy decisions and for the ultimate work of evaluation-the finding of new ways to measure the main goal of change in fertility by the translation of statistics on Services provided and commercial supplies into birth rate data.
Tierney, Michael L.
The Timmons Savings Plan, which encourages families to save toward college costs, is analyzed. This plan allows for periodic (non-tax deductible) contributions to an account administered by the U.S. Department of the Treasury. The amount deposited would be matched by the federal government in exchange for the government's earning the interest on…
Scales, Kezia; Lepore, Michael; Anderson, Ruth A; McConnell, Eleanor S; Song, Yuting; Kang, Bada; Porter, Kristie; Thach, Trini; Corazzini, Kirsten N
Empowering individuals to direct their own care is central to person-centered care and health care policy. However, there is limited knowledge of how "person-directed care planning" (PDCP) can be achieved in particular settings. This study identifies key structures and processes for operationalizing and implementing PDCP in nursing homes. Using participatory inquiry, we convened "stakeholder engagement sessions" with residents, families, nursing staff, and managers/administrators in two North Carolina nursing homes ( N = 24 sessions; N = 67 unique participants). Stakeholders discussed current care-planning processes and provided feedback on an emergent conceptual framework of PDCP. Three themes emerged through directed-content analysis: strategies included providing formal and informal opportunities to engage in care planning and ensuring effective follow-through; different roles were required among leadership, staff, residents, and families to accomplish PDCP; and limits on achieving PDCP included competing priorities and perceived regulatory and resource constraints. Results are discussed in terms of the specific competencies required for accomplishing PDCP.
DeMino, Kathleen A; Appleby, George; Fisk, Deborah
This study compared the perception of social support and the degree of internalized homophobia for two demographically similar groups: lesbians with planned families and lesbians who did not have children. Results found that lesbians with planned families perceived significantly less social support from friends overall, from gay men and lesbian friends specifically, and more support from their families-of-origin than lesbians who did not have children. Lesbians with planned families also reported significantly higher internalized homophobia specific to disclosure of sexual identification. The authors suggest that selective disclosure may be an adaptive response rather than a true measure of internalized homophobia.
Gizachew Assefa Tessema
Full Text Available Improving use of family planning services is key to improving maternal health in Africa, and provision of quality of care in family planning services is critical to support higher levels of contraceptive uptake. The objective of this systematic review was to synthesize the available evidence on factors determining the quality of care in family planning services in Africa.Quantitative and qualitative studies undertaken in Africa, published in English, in grey and commercial literature, between 1990 and 2015 were considered. Methodological quality of included studies was assessed using standardized tools. Findings from the quantitative studies were summarized using narrative and tables. Client satisfaction was used to assess the quality of care in family planning services in the quantitative component of the review. Meta-aggregation was used to synthesize the qualitative study findings.From 4334 records, 11 studies (eight quantitative, three qualitative met the review eligibility criteria. The review found that quality of care was influenced by client, provider and facility factors, and structural and process aspects of the facilities. Client's waiting time, provider competency, provision/prescription of injectable methods, maintaining privacy and confidentiality were the most commonly identified process factors. The quality of stock inventory was the most commonly identified structural factor. The quality of care was also positively associated with privately-owned facilities. The qualitative synthesis revealed additional factors including access related factors such as 'pre-requisites to be fulfilled by the clients and cost of services, provider workload, and providers' behaviour.There is limited evidence on factors determining quality of care in family planning services in Africa that shows quality of care is influenced by multiple factors. The evidence suggests that lowering access barriers and avoiding unnecessary pre-requisites for taking
Wegs, Christina; Creanga, Andreea A; Galavotti, Christine; Wamalwa, Emmanuel
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. 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. 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 (pevaluation demonstrates that an intervention that catalyzes open dialogue about gender and FP can shift social norms, enable more equitable couple communication and decision-making and, ultimately, increase use of FP.
Shahid, Shaouli; Durey, Angela; Bessarab, Dawn; Aoun, Samar M; Thompson, Sandra C
Aboriginal Australians experience poorer outcomes from cancer compared to the non-Aboriginal population. Some progress has been made in understanding Aboriginal Australians' perspectives about cancer and their experiences with cancer services. However, little is known of cancer service providers' (CSPs) thoughts and perceptions regarding Aboriginal patients and their experiences providing optimal cancer care to Aboriginal people. Communication between Aboriginal patients and non-Aboriginal health service providers has been identified as an impediment to good Aboriginal health outcomes. This paper reports on CSPs' views about the factors impairing communication and offers practical strategies for promoting effective communication with Aboriginal patients in Western Australia (WA). A qualitative study involving in-depth interviews with 62 Aboriginal and non-Aboriginal CSPs from across WA was conducted between March 2006-September 2007 and April-October 2011. CSPs were asked to share their experiences with Aboriginal patients and families experiencing cancer. Thematic analysis was carried out. Our analysis was primarily underpinned by the socio-ecological model, but concepts of Whiteness and privilege, and cultural security also guided our analysis. CSPs' lack of knowledge about the needs of Aboriginal people with cancer and Aboriginal patients' limited understanding of the Western medical system were identified as the two major impediments to communication. For effective patient-provider communication, attention is needed to language, communication style, knowledge and use of medical terminology and cross-cultural differences in the concept of time. Aboriginal marginalization within mainstream society and Aboriginal people's distrust of the health system were also key issues impacting on communication. Potential solutions to effective Aboriginal patient-provider communication included recruiting more Aboriginal staff, providing appropriate cultural training for CSPs
Full Text Available Abstract Background In Brazil, a Ministry of Health report revealed women who underwent an abortion were predominantly in the use of contraceptive methods, but mentioned inconsistent or erroneously contraceptive use. Promoting the use of contraceptive methods to prevent unwanted pregnancies is one of the most effective strategies to reduce abortion rates and maternal morbidity and mortality. Therefore, providing post-abortion family planning services that include structured contraceptive counseling with free and easy access to contraceptive methods can be suitable. So the objective of this study is to determine the acceptance and selection of contraceptive methods followed by a post-abortion family planning counseling. Methods A cross-sectional study was carried out from July to October 2008, enrolling 150 low income women to receive post-abortion care at a family planning clinic in a public hospital located in Recife, Brazil. The subjects were invited to take part of the study before receiving hospital leave from five different public maternities. An appointment was made for them at a family planning clinic at IMIP from the 8th to the 15th day after they had undergone an abortion. Every woman received information on contraceptive methods, side effects and fertility. Counseling was individualized and addressed them about feelings, expectations and motivations regarding contraception as well as pregnancy intention. Results Of all women enrolled in this study, 97.4% accepted at least one contraceptive method. Most of them (73.4% had no previous abortion history. Forty of the women who had undergone a previous abortion, 47.5% reported undergoing unsafe abortion. Slightly more than half of the pregnancies (52% were unwanted. All women had knowledge of the use of condoms, oral contraceptives and injectables. The most chosen method was injectables, followed by oral contraceptives and condoms. Only one woman chose an intrauterine device. Conclusion The
Full Text Available Physicians with expertise in providing training for family medicine, at both undergraduate level and postgraduate level, are frequently invited to run training workshops in countries with developing systems of family medicine but this approach is often a challenge for the incoming external trainers. There are general challenges in working across different contexts, especially cultural factors, the different approaches to training, including the aims, methods, and assessment, and additional organizational factors, influenced by the wider sociopolitical environment of the host country. Practical responses to these challenges are discussed, with relevance to both external trainers and those responsible for requesting training. This commentary contains insights from the experiences of the authors in providing training for family medicine in China.
The Polish Senate proposed an anti-abortion law that less 5 main points: the one performing the abortion can be sentenced for up to 2 years of imprisonment, women who induce or allow someone to abort their fetus are not subject to punishment, abortions done to save the life of the woman or because the pregnancy was induced by an illegal act are exempt, a tribunal can renounce the penalty, and persons who use force or threat to induce an abortion can be sentenced for up to 5 years of imprisonment. The bill must go to the Parliament and pass in order to become a law. This proposed bill has caused a large scale public debate. Many women and doctors have publicly protested against the bill. The political force behind the bill is the Catholic population of Poland, including the Catholic Church. The current abortion law in Poland adopted in 1956 allows for the abortion for social indications, until week 20; medical indications, until the 2nd trimester; or when pregnancy was a result of rape. The law resulted an elimination of deaths related to abortion, also a reduction in the number of miscarriages. However since 1955 the number of abortions performed has increased. Causes are low levels of sexual knowledge in the public, few contraceptives, and limited sexual education. The abortion issue represents a larger problem in Polish society. The lack of governmental sponsored family planning results in a large number of unintended pregnancies. It is the author's opinion that the women of Poland should be allowed to have the choice to have an abortion.
In Brazilian Congress, the importance of family planning has, for historical reasons, been confused with controlling population growth. The question is mostly related to the iniquitous distribution of wealth rather than overpopulation. The populations of developed countries consume energy, primary materials, and foodstuffs for a comfortable living, however, a large part of the populations in countries on the peripheries barely survive with incomes below the poverty line. In Brazil, the richest 10% possess half of the national wealth, and the remaining 90% are left with the other half. Most of all, the lack of access to produced wealth is the reason why the majority do not have access to health care, education, leisure, information, culture, and the conditions of living with dignity. The adoption of contraceptive methods is intimately associated with the level of culture and information of the population. The majority of women desire to use some kind of contraceptive method. It is imperative that the state grant to the women and men who so desire access to the materials and necessary information in order to choose the number of children they desire. The Ministry of Health has run for almost a decade a program for maternal health (PAISM), although it has not been fully implemented, and the benefits of this program have remained inaccessible to large numbers of women, especially in the large metropolises. In Brazil, about 30% of women of reproductive age undergo sterilization, as opposed to only 7% in developed countries. Those who cannot afford it give birth to children who grow up without education or medical care and become immersed in violence to fight for their survival.
Full Text Available Abstract Background Adolescent pregnancy has significant health and socio-economic consequences for women, their families and communities. Efforts to prevent too-early pregnancy rely on accurate information about adolescents' knowledge, behaviours and access to family planning, however available data are limited in some settings. Demographic and Health Survey (DHS reports are recognised as providing nationally representative data that are accessible to policymakers and programmers. This paper reviews DHS reports for low and lower middle income countries in East Asia and the Pacific to determine what information regarding adolescent fertility and family planning is available, and summarises key findings. Methods The most recent DHS reports were sought for the 33 low and lower middle income countries in the East Asia and Pacific region as defined by UNICEF and World Bank. Age-disaggregated data for all indicators relevant to fertility and current use, knowledge and access to family planning information and services were sought to identify accessible information. Reported data were analysed using an Excel database to determine outcomes for adolescents and compare with adult women. Results DHS reports were available for eleven countries: Cambodia, Indonesia, Marshall Islands, Nauru, Papua New Guinea, Philippines, Samoa, Solomon Islands, Timor-Leste, Tuvalu and Vietnam. Twenty seven of 40 relevant DHS indicators reported outcomes for adolescent women aged 15-19 years. There were limited data for unmarried adolescents. A significant proportion of women commence sexual activity and childbearing during adolescence in the context of low contraceptive prevalence and high unmet need for contraception. Adolescent women have lower use of contraception, poorer knowledge of family planning and less access to information and services than adult women. Conclusion DHS reports provide useful and accessible data, however, they are limited by the failure to report
M. T. Iman
Full Text Available The aim of this research is to study those factors which are related to women’s satisfaction of family planning services in the Shiraz city as a south capital city of Iran. Using survey method and questionnaire technique, 384 married women as the clients of Family Planning Centers, were interviewed. Results show that there are positive and significant relationships between independent variables including occupation rank, duration of using services, degree of expectations fulfillment, as well as degree of knowledge about contraceptives, and clients’ satisfaction (dependent variable. Furthermore there are significant and negative relationships between variables such as number of children ever born, number of unintended pregnancies, as well as degree of side effects, and dependent variable. The Path analysis model, explained 54.9 percent of the variation of women's satisfaction of services provided by Family Planning Centers as dependent variable.
Weaver, Ruth Harding
Examined the personal characteristics and resources in 65 licensed family child care providers' lives that influence developmentally enhancing caregiving and professional commitment. Unique predictors to higher quality of care were higher levels of formal education and training, college coursework in early childhood education, higher psychological…
Pediatric healthcare providers' perspectives on barriers to diabetes self-management among youth with type 1 diabetes and strategies to overcome them were explored qualitatively. Family conflict about diabetes care was viewed as a common problem, addressable by behavioral interventions to improve co...
Hogge, Jon; Eborn, Ben; Packham, Joel; Findlay, Reed; Harrison, Steve
Farm succession and estate planning pose difficult challenges for farmers. Idaho farmers generally do not have a business succession plan or an estate plan. Due to the complexities of farm management, University of Idaho Extension personnel partnered with the Idaho Barley Commission and the U.S. Department of Agriculture Risk Management Agency to…
Yuan, Judy Chia-Chun; Kaste, Linda M; Lee, Damian J; Harlow, Rand F; Knoernschild, Kent L; Campbell, Stephen D; Sukotjo, Cortino
This study aims to identify dental students' perceptions of pre-patient care laboratory exercises (PCLEs) and clinical experiences that influence their future plans for providing implant care. One of two questionnaires was administered to dental student classes at one dental school (D2: Survey 1; D3 and D4: Survey 2). Future plans as graduates to provide implant diagnosis and treatment planning (DxTP), restoration of single-tooth implants (STIs), and implant-retained overdentures (IODs) were cross-sectionally assessed along with potential influences such as PCLE, clinical experiences, gender, and class. The majority of students planned to provide implant services after graduation (DxTP 68.9 percent; STI 61.2 percent; IOD 62.1 percent). Bivariately, males reflected more preparedness from PCLEs than females (p=.002) and the D2 students more than D3 and D4 students (pimplant therapy. However, this varied by gender and class. These findings indicate that PCLEs are important for their influence on students' future plans to provide implant therapy. However, further studies are needed to validate actual PCLEs and clinical implant practices (both longitudinally and for other schools) and to determine educational interventions to optimize the provision of implant care.
Vedam, Saraswathi; Stoll, Kathrin; Schummers, Laura; Fairbrother, Nichole; Klein, Michael C; Thordarson, Dana; Kornelsen, Jude; Dharamsi, Shafik; Rogers, Judy; Liston, Robert; Kaczorowski, Janusz
Available birth settings have diversified in Canada since the integration of regulated midwifery. Midwives are required to offer eligible women choice of birth place; and 25-30% of midwifery clients plan home births. Canadian provincial health ministries have instituted reimbursement schema and regulatory guidelines to ensure access to midwives in all settings. Evidence from well-designed Canadian cohort studies demonstrate the safety and efficacy of midwife-attended home birth. However, national rates of planned home birth remain low, and many maternity providers do not support choice of birth place. In this national, mixed-methods study, our team administered a cross-sectional survey, and developed a 17 item Provider Attitudes to Planned Home Birth Scale (PAPHB-m) to assess attitudes towards home birth among maternity providers. We entered care provider type into a linear regression model, with the PAPHB-m score as the outcome variable. Using Students' t tests and ANOVA for categorical variables and correlational analysis (Pearson's r) for continuous variables, we conducted provider-specific bivariate analyses of all socio-demographic, education, and practice variables (n=90) that were in both the midwife and physician surveys. Median favourability scores on the PAPHB-m scale were very low among obstetricians (33.0), moderately low for family physicians (38.0) and very high for midwives (80.0), and 84% of the variance in attitudes could be accounted for by care provider type. Amount of exposure to planned home birth during midwifery or medical education and practice was significantly associated with favourability scores. Concerns about perinatal loss and lawsuits, discomfort with inter-professional consultations, and preference for the familiarity of the hospital correlated with less favourable attitudes to home birth. Among all providers, favourability scores were linked to beliefs about the evidence on safety of home birth, and confidence in their own ability
Frith, Lucy; Blyth, Eric; Lui, Steve
What contact arrangements are established between providers and recipients of embryos using Snowflakes® Embryo Adoption Program? Contact arrangements varied considerably and were generally positively described, although some challenges were acknowledged. Reproductive technologies create new and diverse family forms, and the ways in which families created by embryo adoption are negotiated in practice have not been extensively investigated. This exploratory, mixed-methods study had two phases: (i) an online survey (open May-September 2013) and (ii) qualitative semi-structured interviews by email (conducted between 2014 and 2015), exploring participants' experiences of contact with their embryo provider or recipient. Phase I included 17 providers (14 women and 3 men) and 28 recipients (27 women and 1 man). Phase II included 8 providers (5 women and 3 men) and 12 recipients (10 women and 2 men). All participants, except one, were located in the US. This study illustrates how embryo adoption in the US, as a form of conditional donation, can operate and how the participants define and negotiate these emerging relationships. All families were open with their children about how they were conceived and early contact between recipients and providers (frequently before birth) was valued. On the whole, participants were happy with the amount and type of contact they had, and where the current contact did not involve the children, it was seen as a way of keeping the channels open for future contact when the children were older. Participants often portrayed the opportunities for contact as being in the best interests of the child. The study participants are a particular group who had chosen to either receive or give their embryos via a conditional embryo adoption agency in the US and had established contact. Therefore, this is not a representative sample of those who provide or receive embryos for family building. This embryo adoption model clearly fulfils a need; some people
Verkuyl, Douwe Arie Anne
This thesis explores the demand for family planning (FP) in the region and demonstrates that just at the time that demand takes off the brain drain and economic situation make it unlikely that the required services will be provided. This, increasingly, results in unsafe abortions. FP in Zimbabwe is
The population explosion has been abating since the 2nd half of the 1960s. The birth rate of the 3rd World dropped from 45/1000 during 1950-55 to 31/1000 during 1985-90. From the 1st half of the 1960s to the 1st half of the 1980s the total fertility of such countries dropped from 6.1 to 4.2 children/woman. In Taiwan, Singapore, Hong Kong, South Korea, and Malaysia living standards improved as a result of industrialization, and fertility decreased significantly. In Sri Lanka, China, North Vietnam, and Thailand the drop of fertility is explained by cultural and religious factors. In 1982 about 78% of the population of developing countries lived in 39 states that followed an official policy aimed at reducing the population. Another 16% lived in countries supporting the concept of a desired family size. However, World Bank data showed that in the mid-1980s in 27 developing countries no state family planning (FP) programs existed. India adopted an official FP program in 1952, Pakistan followed suit in 1960, South Korea in 1961, and China in 1962. In Latin America a split policy manifested itself: in Brazil birth control was rejected, only Colombia had a FP policy. In 1986 the governments of 68 of 131 developing countries representing 3.1 billion people considered the number of children per woman too high. 31 of these countries followed concrete population control policies. On the other hand, in 1986 24 countries of Africa with 40% of the continent's population took no measures to influence population growth. In Latin America and the Caribbean 18 of 33 countries were idle, except for Mexico that had a massive state FP program. These programs also improve maternal and child health with birth spacing of at least 2 years, and the prevention of pregnancies of too young women or those over 40. The evaluation of rapidly spreading FP programs in the 1970s was carried out by the World Fertility Survey in 41 countries. The impact of FP programs was more substantial than
Full Text Available Unwanted pregnancies with their negative impact on both women and children occur on an ongoing basis in Gauteng, South Africa. One way to prevent unwanted pregnancies is to use a reliable contraceptive method available free of charge from primary health care clinics providing family planning services throughout Gauteng Province. A literature review was completed on women and access to family planning services and an interview schedule (questionnaire was developed. The purpose of this study was to describe guidelines to meet the expectations of clients accessing family planning services provided by a clinic in Region F, Area 28 of the Greater Johannesburg metropolitan council. This quantitative, exploratory, descriptive and comparative study measured the gaps between the expectations of participants on service delivery and the extent to which these expectations were met. A convenience sample was conducted and consisted of 50 women of reproductive age (ages 15 to 49 attending the family planning clinic. Pre-testing of the instrument was conducted. Structured interviews with a interview schedule were conducted before and after women attended a family planning service. Inferential statistics indicated that there was a significant gap between the client expectations of family planning service delivery and the extent to which these expectations were met. Of the sixty-four items where women indicated the extent of their expectations the findings on only three items were not statistically significant. These gaps were addressed by proposing managerial guidelines to be implemented by the nurse manager in charge of the facility, on which this article will focus. Validity and reliability principles were ensured in the study. Ethical principles were adhered to during the research process.
Tay, Keson; Yu Lee, Rachel Jia; Sim, Shin Wei; Menon, Sumytra; Kanesvaran, Ravindran; Radha Krishna, Lalit Kumar
Advanced care plans (ACPs) are designed to convey the wishes of patients with regards to their care in the event of incapacity. There are a number of prerequisites for creation of an effective ACP. First, the patient must be aware of their condition, their prognosis, the likely trajectory of the illness, and the potential treatment options available to them. Second, patient input into ACP must be free of any coercive factors. Third, the patient must be able to remain involved in adapting their ACP as their condition evolves. Continued use of familial determination and collusion within the local healthcare system, however, has raised concerns that the basic requirements for effective ACP cannot be met. To assess the credibility of these concerns, we employed a video vignette approach depicting a family of three adult children discussing whether or not to reveal a cancer diagnosis to their mother. Semistructured interviews with 72 oncology patients and 60 of their caregivers were conducted afterwards to explore the views of the participants on the different positions taken by the children. Collusion, family-centric decision making, adulteration of information provided to patients, and circumnavigation of patient involvement appear to be context-dependent. Patients and families alike believe that patients should be told of their conditions. However, the incidence of collusion and familial determination increases with determinations of a poor prognosis, a poor anticipated response to chemotherapy, and a poor premorbid health status. Financial considerations with respect to care determinations remain secondary considerations. Our data suggest that ACPs can be effectively constructed in family-centric societies so long as healthcare professionals continue to update and educate families on the patient's situation. Collusion and familial intervention in the decision-making process are part of efforts to protect the patient from distress and are neither solely dependent on
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.
Criniti, Shannon M; Aaron, Erika; Hilley, Amy; Wolf, Sandra
Family planning centers can play an important role in HIV screening, education, and risk-reduction counseling for women who are sexually active. This article describes how 1 urban Title X-funded family planning clinic transitioned from using a designated HIV counselor for targeted testing to a model that uses clinic staff to provide integrated, routine, nontargeted, rapid HIV testing as standard of care. Representative clinic staff members developed an integrated testing model that would work within the existing clinic flow. Education sessions were provided to all staff, signs promoting routine HIV testing were posted, and patient and clinician information materials were developed. A review of HIV testing documentation in medical charts was performed after the new model of routine, nontargeted, rapid HIV testing was integrated, to determine any changes in patient testing rates. A survey was given to all staff members 6 months after the transition to full integration of HIV testing to evaluate the systems change process. Two years after the transition, the rate of patients with an HIV test in the medical chart within the last 12 months increased 25.5%. The testing acceptance rate increased 17%. Sixteen HIV seropositive individuals were identified and linked into medical care. All surveyed clinic staff agreed that offering routine HIV screening to all patients is very important, and 78% rated the integration efforts as successful. Integrating routine HIV screening into a family planning clinic can be critical to identifying new HIV infections in women. This initiative demonstrated that routine, nontargeted, rapid HIV screening can be offered successfully as a standard of care in a high-volume, urban, reproductive health care setting. This description and evaluation of the process of changing the model of HIV testing in a clinic setting is useful for clinicians who are interested in expanding routine HIV testing in their clinics. © 2011 by the American College of
A significant percentage of children in foster care in North America are younger than 1 year of age and are in foster care because of parental substance use and other social challenges. Infants might present with specific health and behavioral issues that are challenging to manage within the foster family home environment; foster families require specialized skills and knowledge to manage these issues. In this article, the author describes a constructivist grounded theory of the process of becoming and providing family foster caregiving in the context of caring for infants with prenatal alcohol and/or drug exposure. The basic social process of (ad)ministering love was identified. The author further describes the three phases of this process and the core concepts within each phase.
Taneja, R N
A study was carried out among the civil and military population in Poona, India, to determine their knowledge, attitude, and practices in relation to family planning and the fertility rates of women aged 15-44 in the following catagories: 1) total and age specific marital fertility rate; 2) order of birth of the children born during the previous year; 3) average number of living children per couple; and 4) percentage of currently pregnant women. 251 civilian wives and 230 military wives were interviewed. Both total marital fertility rates and age specific marital fertility rates were high among the Service families, due perhaps to the predominance of young people in the military. Most of the live births occurring in the previous year were of the 1-3 order. Similarly, the average number of children per couple was low, only 1.7, although the number of children in completed families (4.4) was not too much lower than in civilian Poona families (4.8) and in India in general (5.5). Nearly 2/3 considered 3 children the ideal, although the desire for boys was intense and could lead couples to seek more than 3 children. Only 10% favored abortion on demand. More Service than civilian families knew about and practiced family planning, though the number practicing was only 27.8%. The most widely known methods were sterilization, the condom, and the IUD. The image of family planning among the civilian population was of family limitation, whereas some Service personnel regarded it as a means of child spacing. Practice of family planning was highest among Junior Commissioned Officers, the more literate, and those in the 30-34 age group. There was a positive correlation between family planning practice and number of living children. It is recommended that fertility statistics on military personnel be maintained annually. Further, as it was discovered that 20% of the military wives were currently pregnant, the family welfare planning staff and maternal health services and the
Full Text Available Background and Aim: Iran′s health sector has been engaging the services of physicians and midwives in healthcare centers since 2005, with the hope of improving the quantity and quality of family planning services. The aim of this study was to assess the effect of serving physicians and midwives on the quantity and quality of family planning services in the healthcare centers of Iran. Materials and Methods: The present cross-sectional study (Jan 2010 until Sep 2011 was carried out on 600 eligible families who were clients of healthcare centers of Tabriz, Azarshahr and Osku, cities of Northwest Iran from 2006 until 2011, in two groups (before and after. Some of the characteristics of the participants and the data on the quality and quantity of family planning services provided were grouped in a checklist of 16 variables by comparing the patients′ past medical histories. Results: In comparison with 3 years prior to engaging physician and midwife services in health care centers, the Couple Year Protection (CYP and the quantity of family planning service indexes significantly increased among eligible families. The family size of participants declined significantly after family physicians and midwives became available in the healthcare centers (P < 0.005. Conclusion: Our findings showed some improvement in the quantity of services without any noticeable changes in the quality of services provided as a consequence of this huge intervention. Therefore, it is suggested that there should be proper oversight of the duties of the health team in order to keep a close watch on primary healthcare, design of proper mechanisms for collecting and maintaining performance reports and statistics, and continuously monitor and control the quality of services.
The basic elements of a successful family planning (FP) program are variable between countries. Providing better access to modern contraceptives, access to general and reproductive health care, and increasing economic and educational opportunities contribute to reducing fertility rates. Effective distribution is constrained by rural, isolated populations and cultural attitudes. Indonesia has used floating clinics located on boats to reach inaccessible areas; Norplant and hormonal injection availability also contribute to the 53% contraceptive prevalence rate. The Japanese Organization for International Cooperation in Family Planning has shipped bicycles to developing countries. The result has been improved status among peers and greater program success. Contraceptive social marketing programs (CSM) have been successful in some countries to distribute contraceptives through local channels such as shops and stalls; people seem willing to pay also. CSM has been successful in Egypt in increasing condom sales. IUD use increased from 11% to 42% between 1975-88 with CSM. Multimedia promotion that is carefully researched and targeted is another way to increase contraceptive prevalence (CP) rates. A Brazilian multimedia vasectomy campaign led to an 80% monthly increase in Pro-Pater male health clinics. 240,000 women in Turkey were encouraged through multimedia efforts to switch to modern methods. In Zimbabwe, men have been the target of efforts to educate them about the advantages of small families. Women are recruited to implement FP services in INdia and in poor neighborhoods; an increase from 12% to 61% was achieved. Highly motivated workers with a respect for the community's values is essential to any successful FP program as is government support. China's policy has drawn criticism; China has welcomed a UN program which provides financial motivation. Thailand has been successful due to the commitment between public and private sectors; in 17 years CP rose from 10% to
Lindvall, Agneta; Kristensson, Jimmie; Willman, Ania; Holst, Göran
HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.3 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Informal Care Provided by Family Caregivers: Experiences of Older Adults With Multimorbidity" found on pages 24-31, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until July 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Describe how older adults with multimorbidity experience care provided from informal/family
Full Text Available A significant number of women in low and middle income countries (L-MICs who need any family planning, experience a lack in access to modern effective methods. This study was conducted to review potential cost effectiveness of scaling up family planning interventions in these regions from the published literatures and assess their implication for policy and future research.A systematic review was performed in several electronic databases i.e Medline (Pubmed, Embase, Popline, The National Bureau of Economic Research (NBER, EBSCOHost, and The Cochrane Library. Articles reporting full economic evaluations of strategies to improve family planning interventions in one or more L-MICs, published between 1995 until 2015 were eligible for inclusion. Data was synthesized and analyzed using a narrative approach and the reporting quality of the included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS statement.From 920 references screened, 9 studies were eligible for inclusion. Six references assessed cost effectiveness of improving family planning interventions in one or more L-MICs, while the rest assessed costs and consequences of integrating family planning and HIV services, concerning sub-Saharan Africa. Assembled evidence suggested that improving family planning interventions is cost effective in a variety of L-MICs as measured against accepted international cost effectiveness benchmarks. In areas with high HIV prevalence, integrating family planning and HIV services can be efficient and cost effective; however the evidence is only supported by a very limited number of studies. The major drivers of cost effectiveness were cost of increasing coverage, effectiveness of the interventions and country-specific factors.Improving family planning interventions in low and middle income countries appears to be cost-effective. Additional economic evaluation studies with improved reporting quality are necessary
Speizer, Ilene S; Nanda, Priya; Achyut, Pranita; Pillai, Gita; Guilkey, David K
Family planning has widespread positive impacts for population health and well-being; contraceptive use not only decreases unintended pregnancies and reduces infant and maternal mortality and morbidity, but it is critical to the achievement of Millennium Development Goals. This study uses baseline, representative data from six cities in Uttar Pradesh, India to examine family planning use among the urban poor. Data were collected from about 3,000 currently married women in each city (Allahabad, Agra, Varanasi, Aligarh, Gorakhpur, and Moradabad) for a total sample size of 17,643 women. Participating women were asked about their fertility desires, family planning use, and reproductive health. The survey over-sampled slum residents; this permits in-depth analyses of the urban poor and their family planning use behaviors. Bivariate and multivariate analyses are used to examine the role of wealth and education on family planning use and unmet need for family planning. Across all of the cities, about 50% of women report modern method use. Women in slum areas generally report less family planning use and among those women who use, slum women are more likely to be sterilized than to use other methods, including condoms and hormonal methods. Across all cities, there is a higher unmet need for family planning to limit childbearing than for spacing births. Poorer women are more likely to have an unmet need than richer women in both the slum and non-slum samples; this effect is attenuated when education is included in the analysis. Programs seeking to target the urban poor in Uttar Pradesh and elsewhere in India may be better served to identify the less educated women and target these women with appropriate family planning messages and methods that meet their current and future fertility desire needs.
Zakiyah, Neily; van Asselt, Antoinette D I; Roijmans, Frank; Postma, Maarten J
A significant number of women in low and middle income countries (L-MICs) who need any family planning, experience a lack in access to modern effective methods. This study was conducted to review potential cost effectiveness of scaling up family planning interventions in these regions from the published literatures and assess their implication for policy and future research. A systematic review was performed in several electronic databases i.e Medline (Pubmed), Embase, Popline, The National Bureau of Economic Research (NBER), EBSCOHost, and The Cochrane Library. Articles reporting full economic evaluations of strategies to improve family planning interventions in one or more L-MICs, published between 1995 until 2015 were eligible for inclusion. Data was synthesized and analyzed using a narrative approach and the reporting quality of the included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. From 920 references screened, 9 studies were eligible for inclusion. Six references assessed cost effectiveness of improving family planning interventions in one or more L-MICs, while the rest assessed costs and consequences of integrating family planning and HIV services, concerning sub-Saharan Africa. Assembled evidence suggested that improving family planning interventions is cost effective in a variety of L-MICs as measured against accepted international cost effectiveness benchmarks. In areas with high HIV prevalence, integrating family planning and HIV services can be efficient and cost effective; however the evidence is only supported by a very limited number of studies. The major drivers of cost effectiveness were cost of increasing coverage, effectiveness of the interventions and country-specific factors. Improving family planning interventions in low and middle income countries appears to be cost-effective. Additional economic evaluation studies with improved reporting quality are necessary to generate
Yin, H Shonna; Gupta, Ruchi S; Tomopoulos, Suzy; Mendelsohn, Alan L; Egan, Maureen; van Schaick, Linda; Wolf, Michael S; Sanchez, Dayana C; Warren, Christopher; Encalada, Karen; Dreyer, Benard P
The use of written asthma action plans (WAAPs) has been associated with reduced asthma-related morbidity, but there are concerns about their complexity. We developed a health literacy-informed, pictogram- and photograph-based WAAP and examined whether providers who used it, with no training, would have better asthma counseling quality compared with those who used a standard plan. Physicians at 2 academic centers randomized to use a low-literacy or standard action plan (American Academy of Allergy, Asthma and Immunology) to counsel the hypothetical parent of child with moderate persistent asthma (regimen: Flovent 110 μg 2 puffs twice daily, Singulair 5 mg daily, Albuterol 2 puffs every 4 hours as needed). Two blinded raters independently reviewed counseling transcriptions. medication instructions presented with times of day (eg, morning and night vs number of times per day) and inhaler color; spacer use recommended; need for everyday medications, even when sick, addressed; and explicit symptoms used. 119 providers were randomly assigned (61 low literacy, 58 standard). Providers who used the low-literacy plan were more likely to use times of day (eg, Flovent morning and night, 96.7% vs 51.7%, P counseling time was similar (3.9 [2.5] vs 3.8 [2.6] minutes, P = .8). Use of a low-literacy WAAP improves the quality of asthma counseling by helping providers target key issues by using recommended clear communication principles. Copyright © 2016 by the American Academy of Pediatrics.
Curry, Dora Ward; Rattan, Jesse; Huang, Shuyuan; Noznesky, Elizabeth
An estimated 43 million women of reproductive age experienced the effects of conflict in 2012. Already vulnerable from the insecurity of the emergency, women must also face the continuing risk of unwanted pregnancy but often are unable to obtain family planning services. The ongoing Supporting Access to Family Planning and Post-Abortion Care (SAFPAC) initiative, led by CARE, has provided contraceptives, including long-acting reversible contraceptives (LARCs), to refugees, internally displaced persons, and conflict-affected resident populations in Chad, the Democratic Republic of the Congo (DRC), Djibouti, Mali, and Pakistan. The project works through the Ministry of Health in 4 key areas: (1) competency-based training, (2) supply chain management, (3) systematic supervision, and (4) community mobilization to raise awareness and shift norms related to family planning. This article presents data on program results from July 2011 to December 2013 from the 5 countries. Project staff summarized monthly data from client registers using hard-copy forms and recorded the data electronically in Microsoft Excel for compilation and analysis. The initiative reached 52,616 new users of modern contraceptive methods across the 5 countries, ranging from 575 in Djibouti to 21,191 in Chad. LARCs have predominated overall, representing 61% of new modern method users. The percentage of new users choosing LARCs varied by country: 78% in the DRC, 72% in Chad, and 51% in Mali, but only 29% in Pakistan. In Djibouti, those methods were not offered in the country through SAFPAC during the period discussed here. In Chad, the DRC, and Mali, implants have been the most popular LARC method, while in Pakistan the IUD has been more popular. Use of IUDs, however, has comprised a larger share of the method mix over time in all 4 of these countries. These results to date suggest that it is feasible to work with the public sector in fragile, crisis-affected states to deliver a wide range of quality
Background Average contraceptive prevalence rate in the Nkwanta district of Ghana was estimated to be 6.2% relative to the national average at the time, of 19%. While several efforts had been made to improve family planning in the country, the district still had very low use of modern family planning methods. This study sought to determine the factors that influenced modern family planning use in general and specifically, the factors that determined the consistently low use of modern family planning methods in the district. Methods A case–control study was conducted in the Nkwanta district of Ghana to determine socio-economic, socio-cultural and service delivery factors influencing family planning usage. One hundred and thirty cases and 260 controls made up of women aged 15–49 years were interviewed using structured questionnaires. A logistic regression was fitted. Results Awareness and knowledge of modern family planning methods were high among cases and controls (over 90%). Lack of formal education among women, socio-cultural beliefs and spousal communication were found to influence modern family planning use. Furthermore, favourable opening hours of the facilities and distance to health facilities influenced the use of modern contraceptives. Conclusion While modern family planning seemed to be common knowledge among these women, actual use of such contraceptives was limited. There is need to improve use of modern family planning methods in the district. In addition to providing health facilities and consolidating close-to-client service initiatives in the district, policies directed towards improving modern family planning method use need to consider the influence of formal education. Promoting basic education, especially among females, will be a crucial step as the district is faced with high levels of school dropout and illiteracy rates. PMID:25117887
Eliason, Sebastian; Awoonor-Williams, John K; Eliason, Cecilia; Novignon, Jacob; Nonvignon, Justice; Aikins, Moses
Average contraceptive prevalence rate in the Nkwanta district of Ghana was estimated to be 6.2% relative to the national average at the time, of 19%. While several efforts had been made to improve family planning in the country, the district still had very low use of modern family planning methods. This study sought to determine the factors that influenced modern family planning use in general and specifically, the factors that determined the consistently low use of modern family planning methods in the district. A case-control study was conducted in the Nkwanta district of Ghana to determine socio-economic, socio-cultural and service delivery factors influencing family planning usage. One hundred and thirty cases and 260 controls made up of women aged 15-49 years were interviewed using structured questionnaires. A logistic regression was fitted. Awareness and knowledge of modern family planning methods were high among cases and controls (over 90%). Lack of formal education among women, socio-cultural beliefs and spousal communication were found to influence modern family planning use. Furthermore, favourable opening hours of the facilities and distance to health facilities influenced the use of modern contraceptives. While modern family planning seemed to be common knowledge among these women, actual use of such contraceptives was limited. There is need to improve use of modern family planning methods in the district. In addition to providing health facilities and consolidating close-to-client service initiatives in the district, policies directed towards improving modern family planning method use need to consider the influence of formal education. Promoting basic education, especially among females, will be a crucial step as the district is faced with high levels of school dropout and illiteracy rates.
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
Tumlinson, Katherine; Hubacher, David; Wesson, Jennifer; Lasway, Christine
A job aid is a tool, such as a flowchart or checklist, that makes it easier for staff to carry out tasks by providing quick access to needed information. Many public health organizations are engaged in the production of job aids intended to improve adherence to important medical guidelines and protocols, particularly in resource-constrained countries. However, some evidence suggests that actual use of job aids remains low. One strategy for improving utilization is the introduction of job aids in training workshops. This paper summarizes the results of two separate evaluations conducted in Uganda and the Dominican Republic (DR) which measured the usefulness of a series of four family planning checklists 7-24 months after distribution in training workshops. While more than half of the health care providers used the checklists at least once, utilization rates were sub-optimal. However, the vast majority of those providers who utilized the checklists found them to be very useful in their work.
Wohlgemuth, Clare M; Auerbach, Heidi P; Parker, Victoria A
Very little is known about family caregivers who are also geriatrics health care professionals. This exploratory study examines the dual roles of such professionals, the impact of their geriatrics expertise on the care of family members, and the influence of those caregiver experiences on their clinical practice. The research team recruited 16 geriatrics health care professionals who participated in 60- to 90-min individual interviews, based on a semistructured guide. Questions explored participants' dual experiences as geriatrics professionals and as family caregivers. Interviews were audio recorded, transcribed, and analyzed using qualitative data analysis software. Using a thematic analysis approach, the authors identified recurring themes, coding responses into both major themes and subthemes. The authors found 3 major themes: (a) dual role advantages and disadvantages, (b) emotional impact of dual roles, and (c) professional impact of family caregiving. Participants reported their own geriatrics expertise provided both advantages and disadvantages in caring for their older family members. Although their expertise introduced a significant emotional intensity to their personal caregiving experiences, those experiences positively influenced their professional insight, empathy, and advocacy for the caregivers of their own patients. In addition to the well-known burdens of caregiving, a further set of complex stressors is imposed on geriatrics health care professionals serving as family caregivers. The challenges they face despite their expertise also highlight critical challenges facing all caregivers. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
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.
Meiksin, Rebecca; Meekers, Dominique; Thompson, Susan; Hagopian, Amy; Mercer, Mary Anne
Patriarchal traditions and a history of armed conflict in Timor-Leste provide a context that facilitates violence against women. More than a third of ever-married Timorese women report physical and/or sexual domestic violence (DV) perpetrated by their most recent partner. DV violates women's rights and may threaten their reproductive health. Marital control may also limit women's reproductive control and healthcare access. Our study investigated relationships between DV and marital control and subsequent family planning, maternal healthcare, and birth outcomes in Timor-Leste. Using logistic regression, we examined 2009-2010 Demographic and Health Survey data from a nationally representative sample of 2,951 women in Timor-Leste. We controlled for age, education, and wealth. We limited our analyses of pregnancy- and birth-related outcomes to those from the 6 months preceding the survey. Rural women with controlling husbands were less likely than other rural women to have an unmet need for family planning (Adj. OR 0.6; 95 % CI 0.4-0.9). Rural women who experienced DV were more likely than other rural women to have an unplanned pregnancy (Adj. OR 2.6; 95 % CI 1.4-4.8), fewer than four antenatal visits (Adj. OR 2.3; 95 % CI 1.1-4.9), or a baby born smaller than average (Adj. OR 3.1; 95 % CI 1.4-6.7). DV and marital control were not associated with the tested outcomes among urban women. Given high rates of DV internationally, our findings have important implications. Preventing DV may benefit both women and future generations. Furthermore, rural women who experience DV may benefit from targeted interventions that mediate associated risks of negative family planning, maternal healthcare, and birth outcomes.
Shriner, Michael; Schlee, Bethanne M.; Mullis, Ronald L.; Cornille, Thomas A.; Mullis, Ann K.
Federal and State Governments provide childcare subsidies for low-income working families. This study compares the encountered issues and working environments of family home providers of subsidized and non-subsidized childcare. Questionnaires were distributed throughout a southeastern state in the United States to 548 family home childcare…
Thind, Amardeep; Liu, Yihang; Maly, Rose
Purpose There is little evidence to document patient satisfaction with follow up care provided by family physicians/general practitioners (FP/GP) to breast cancer patients. We aimed to identify determinants of satisfaction with such care in low-income medically underserved women with breast cancer. Methods Cross sectional study of 145 women who reported receiving follow up care from a FP/GP. Women were enrolled in California’s Breast and Cervical Cancer Treatment Program and were interviewed by phone 3 years after breast cancer diagnosis. Cleary and McNeil’s model, which states that patient satisfaction is a function of patient characteristics, structure of care, and processes of care, was used to understand the determinants of satisfaction. Stepwise logistic regression was used to identify significant predictors. Results 73.4% reported that they were extremely satisfied with their treatment by the family physician/general practitioner. Women who were able to ask their family physicians questions about their breast cancer had six times greater odds of being extremely satisfied compared to women who were not able to ask any questions. Women who scored the family physician higher on the ability to explain things in a way she could understand had a higher odds of being extremely satisfied compared to women who scored their family physicians lower. Conclusions FP/GPs providing follow up care for breast cancer patients should encourage patients to ask questions, and must communicate in a way that patients understand. These recommendations are congruent with the characteristics of patient centered communication for cancer patients enunciated in a recent NCI monograph. PMID:22086814
In 2005, the percentage of Americans with employer-provided health insurance fell for the fifth year in a row. Workers and their families have been falling into the ranks of the uninsured at alarming rates. The downward trend in employer-provided coverage for children also continued into 2005. In the previous four years, children were less likely to become uninsured as public sector health coverage expanded, but in 2005 the rate of uninsured children increased. While Medicaid and SCHIP still work for many, the government has not picked up coverage for everybody who lost insurance. The weakening of this system-notably for children-is particularly difficult for workers and their families in a time of stagnating incomes. Furthermore, these programs are not designed to prevent low-income adults or middle- or high-income families from becoming uninsured. Government at the federal and state levels has responded to medical inflation with policy changes that reduce public insurance eligibility or with proposals to reduce government costs. Federal policy proposals to lessen the tax advantage of workplace insurance or to encourage a private purchase system could further destabilize the employer-provided system. Now is a critical time to consider health insurance reform. Several promising solutions could increase access to affordable health care. The key is to create large, varied, and stable risk pools.
Taylor, April; Lizzi, Michele; Marx, Alison; Chilkatowsky, Maryann; Trachtenberg, Symme W; Ogle, Sue
Care coordination has been a key theme in national forums on healthcare quality, design, and improvement. This article describes the characteristics of a care coordination program aimed at supporting families in building care coordination competencies and providers in the coordination of care across multiple specialties. The program included implementation of a Care Coordination Counselor (CC Counselor) and several supporting tools-Care Binders, Complex Scheduling, Community Resources for Families Database, and a Care Coordination Network. Patients were referred by a healthcare provider to receive services from the CC Counselor or to receive a Care Binder organizational tool. To assess the impact of the counselor role, we compared patient experience survey results from patients receiving CC Counselor services to those receiving only the Care Binder. Our analysis found that patients supported by the CC Counselor reported greater agreement with accessing care coordination resources and identifying a key point person for coordination. Seventy-five percent of CC Counselor patients have graduated from the program. Our findings suggest that implementation of a CC Counselor role and supporting tools offers an integrative way to connect patients, families, and providers with services and resources to support coordinated, continuous care. © 2012 National Association for Healthcare Quality.
Darney, P D
A 1968 study of family size aspirations and attitudes toward contraception and the effects of overpopulation was conducted by interviewing 20 randomly selected third-year medical students and their wives from the University of California and 20 San Francisco State College students and their wives. Couples in the 2 groups were compared to each other, as were persons desiring small families (2 or fewer children) to those wanting large families (4 or more children). Although more medical students expected large families than State college couples (50% compared to less than 20%), a majority of both groups expected more children than they considered ideal for the average American family (a mean of 2.5 children). Overpopulation was considered almost unanimously to be a problem, but much of the blame for crowding in the U.S. was placed on members of lower socioeconomic classes. All couples practiced contraception. Those expecting large families (75% medical students) expressed less concern about future overpopulation problems and financial disadvantages of large families. A change in basic attitude towards responsibility of population growth seems necessary on the part of many affluent Americans, represented by these students.
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
Quality of facility-based family planning services for adolescents in Malawi: ... 13 to 19 years) had twice the odds of reporting a better experience of care compared to ... Clients seen in facilities under nongovernmental management had better ...
Department of Obstetrics and Gynaecology and 'Department of Microbiology,. University of Ghana ... device (IUCD) was the most common Family Planning method chosen .... Panel B Microscopy of wet preparation and grain stain. Gram stain ...
Rakhshani, F; Niknami, S; Ansari Moghaddam, A R
A qualitative study in Zahedan, Islamic Republic of Iran, used focus group discussions with 120 people in 8 main groups to understand more about couple's decision-making and the role of men in family planning. The study included men and women from Sunni and Shia sects as well as theologians from both sects. Shiites, lay people and theologians, believed that both husband and wife play a major role in decision-making about family planning, while Sunnis believed that men are the main decision-makers. All participants believed that men have an important role in family planning, but also that men do not like attending family planning clinics. Religious tenets were important in couple's decision-making about using contraceptives but there were confusions over different teachings.
An examination of postpartum family planning in western Kenya: “I want to use contraception but I have not been told how to do so”. V Naanyu, J Baliddawa, E Peca, J Karfakis, N Nyagoha, B Koech ...
Kabir, M; Islam, M A
A sample of 871 currently married urban Bangladeshi women was used to assess the impact of mass media family planning programmes on current contraceptive use. The analyses suggested that radio had been playing a significant role in spreading family planning messages among eligible clients; 38% of women with access to a radio had heard of family planning messages while the figures for TV and newspaper were 18.5% and 8.5% respectively. Education, number of living children and current contraceptive use were important predictors of exposure to any mass media family planning messages. There was a negative relationship between breast-feeding and the current use of contraception indicating a low need for contraception among women who were breast-feeding.
Rosales Aujang, Enrique; Felguérez Flores, Jesús Alberto
Familiar planning is an important branch of the preventive medicine that can have a great impact on the health of the humanity. The present study is an evaluation by a cross section of the effects obtained by the program of familiar planning during a period of 15 years in the Aguascalientes Delegation of the Mexican Institute of the Social Security, establishing therefore a diagnosis and identifying elements that can contribute in the suitable planning of strategies to improve the quality of the attention and to respond to social and health necessities of the population.
Wilder, E I
This paper uses data from the 1974-1975 Israel Fertility Survey and the 1987-1988 Study of Fertility and Family Formation to examine trends in fertility control among ethnoimmigrant groups in Israel. From 1974 to 1988, Israel underwent extremely rapid economic growth and there occurred what might be considered a contraceptive revolution in the realm of family planning. Specifically, the nonuse of family planning and reliance on less effective techniques of fertility control (withdrawal and abortion) were largely replaced by more efficient modes (e.g., pill, IUD) of family size limitation. In addition, ethnic differences in patterns of fertility control diminished. Meanwhile, socioeconomic and cultural variables such as religiosity and income maintained their importance as determinants of variation of family planning practices among Israeli women.
partner's approval. Difference between the meaning of approval and encouragement should be explored. Interventions involving information education and communication campaigns geared to men and promoting male involvement in family ...
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
Laird, John E; Tolentino, Jerlyn C; Gray, Cynthia
Using the proper greeting may be important to help establish rapport between health care providers and their patients. It may be particularly useful for family medicine physicians working in a military medical facility, where military rank and traditions are important. A total of 259 anonymous surveys were collected from patients treated at a military family medicine clinic. Most of the patients who completed the survey preferred to shake hands with their provider, be greeted using only their first name, and preferred that the provider introduce themselves using their last name only. Active duty patients were more likely than civilians to prefer a handshake (odds ratio [OR] 3.05, 95% confidence interval [CI] 1.46-6.39) and officers were more likely to prefer a handshake compared to enlisted service members (OR 3.29; 95% CI 1.18-9.20). Respondents who were older were more likely to prefer a formal introduction by their provider compared to respondents under 35 years old (OR 2.92, 95% CI 1.35-6.31). Although most patients in this facility expressed a preference for how they would like to be greeted, providers are still encouraged to ask their patients how they would prefer to be addressed. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.
Parker Oliver, Debra; Demiris, George; Washington, Karla; Kruse, Robin L; Petroski, Greg
Untrained family caregivers struggle with complicated medical management regimens for hospice patients. An intervention was tested to improve caregiver's perception of pain management and patient's pain. The intervention was tested with a 2-group (usual care vs intervention) randomized controlled trial using parallel mixed-methods analysis of 446 caregivers in 3 Midwestern hospice programs representing rural and urban settings. Web conferencing or telephones were used to connect caregivers with the hospice care team during care plan meetings. Caregiver's perceptions of pain management were the primary outcome. Secondary outcomes included caregiver quality of life, patient's pain, and anxiety. Video recordings, field notes, and caregiver and staff interviews provided qualitative data. The overall perception of pain management was not changed by the participation in hospice team meetings. Perceptions of fatalism improved for intervention participants, and the intervention participants perceived their patients' pain was better controlled than those in the control group. The intervention was found to be feasible to deliver in rural areas. Caregiver's anxiety and patient's pain were correlated ( r = .18; P = .003), and subanalysis indicated that caregivers of patients with cancer may benefit more from the intervention than other hospice caregivers. Qualitative analyses provided understanding of caregiver's perceptions of pain, cost, and facilitators and barriers to routine involvement of family in care plan meetings. Limitations and Conclusion: The hospice philosophy is supportive of caregiver involvement in care planning, and technology makes this feasible; the intervention needs modification to become translational as well as additional measurement to assess effectiveness. Caregiver education and emotional support should occur outside the meeting, and a strong leader should facilitate the meeting to control efficiency. Finally, the intervention may benefit caregivers
Ali, Moazzam; Seuc, Armando; Rahimi, Asma; Festin, Mario; Temmerman, Marleen
To develop a global research agenda that will guide investment in effective interventions to satisfy the large unmet need for modern methods of family planning. In a global survey, experts on contraception were invited to identify and rank the types of research that would be needed--and the knowledge gaps that would have to be filled--to reduce the unmet need for family planning in the next decade. The experts were then asked to score the research on a given topic in terms of the likelihood of its leading to an intervention that would: (i) be deliverable, affordable and sustainable; (ii) substantially reduce the unmet need for contraceptives; (iii) be effective and efficient in improving health systems; (iv) be ethically implemented; and (v) improve equity in the target population. The overall scores were then ranked. Most of the topics that received the 15 highest scores fell into three categories: implementation of policies in family planning; the integration of services to address barriers to contraceptive use; and interventions targeted at underserved groups, such as adolescents. Experts on contraception gave top priority ranking to research on improving the implementation and integration of health services and on strengthening the health systems supporting family planning services. The results of the exercise may help decision-makers, researchers and funding agencies to develop a clear and focused approach to satisfying the global need for family planning and reach the target set by the Family Planning 2020 initiative.
Full Text Available Contraceptive use during the postpartum period is critical for maternal and child health. However, little is known about the use of family planning and the determinants in Nepal during this period. This study explored pregnancy spacing, unmet need, family planning use, and fertility behaviour among postpartum women in Nepal using child level data from the Nepal Demographic and Health Surveys 2011. More than one-quarter of women who gave birth in the last five years became pregnant within 24 months of giving birth and 52% had an unmet need for family planning within 24 months postpartum. Significantly higher rates of unmet need were found among rural and hill residents, the poorest quintile, and Muslims. Despite wanting to space or limit pregnancies, nonuse of modern family planning methods by women and returned fertility increased the risk of unintended pregnancy. High unmet need for family planning in Nepal, especially in high risk groups, indicates the need for more equitable and higher quality postpartum family planning services, including availability of range of methods and counselling which will help to further reduce maternal, perinatal, and neonatal morbidity and mortality in Nepal.
Foster care is a system created to protect children from an unsafe home environment yet multiple foster home placements, conflictual or nonexistent relationships between foster parents and birth parents, long, drawn out court battles, and living in an on-going state of not knowing when or if they will be going home are just some of the challenges many children in care are expected to manage. This paper presents a guide for therapists working with families involved in foster care. Utilizing ideas from the postmodern therapies and structural family therapy, suggestions will be provided about who needs to talk to whom about what, when to have these necessary conversations, and how to talk to people in a way that mobilizes adults to take action for the children, with the goal of minimizing postplacement trauma, strengthening and repairing relational bonds, and moving children out of foster care and into permanent homes as quickly as possible.
Pilgrim, Nanlesta A; Cardona, Kathleen M; Pinder, Evette; Sonenstein, Freya L
Family planning service quality and clients' satisfaction with services are important determinants of clients' contraceptive use and continuation. We examine women's experiences at family planning clinics on a range of dimensions, including patient-centered communication (PCC), and identify experiences associated with higher ratings of service quality and satisfaction. New female clients (n = 748), ages 18-35 years, from clinics in three major metropolitan areas completed computer-administered interviews between 2008 and 2009. Factors associated with primary outcomes of service quality and satisfaction were assessed using multinomial and ordinary logistic regression, respectively. Higher scores on a Clinician-Client Centeredness Scale, measuring whether clinicians were respectful, listened, and provided thoughtful explanations, were associated with perceptions of good quality care and being very satisfied. Higher scores on a Clinic Discomfort Scale, measuring staff and waiting-room experiences, were associated with reduced satisfaction. Clients' interactions with clinicians, especially PCC, influence their perceptions of service quality, whereas their satisfaction with services is also influenced by the facility environment. These measures are adaptable for agencies to identify the factors contributing to their own clients' satisfaction-dissatisfaction with care and perceptions of service quality.
The family planning (FP) situation in the Arab world is characterized by country openness to receipt of FP assistance, but some contend that there are insufficient international resources directed to Islamic countries. Funding groups counter than aid is adequate; the Arab countries must wait their turn. There may be confusion about Islamic religious traditions. Interpretations of the Koran regarding contraception and abortion differ even among Muslim leaders and are permissible within the religion. Although most Arab nations accept various forms of contraception, differences exist for sanctioning modern methods, acceptance of sterilization, and legal abortion. In some cases British colonial law imposed harsher penalties for abortion than Islamic law. Lebanese Shiites preach that all birth control methods are the equivalent of abortion; Egyptians permit abortion within the first 3 months. Tunisia allows sterilization and Egypt forbids it. Funding from the IPPF to the Arab world constitutes 11% of the total budget. This percentage is less than funding elsewhere in the world. The UN Population Fund provides 9.8% of funding to only 6 Arab states. The UN justification is that the total population size of the Arab region is a fraction of sub-Saharan Africa, even though the total fertility rates are some of the highest in the world. Charges are made that the US Agency for International Development contributes aid based on political reasons, i.e., Jordan and Egypt receive aid and the Sudan and Yemen do not. The Arab world until recently has also been reluctant to invite the family planning community.
Fehring, Richard J
The purpose of this study was to determine the influence of contraception, abortion, and natural family planning (NFP) on divorce rates of US women of reproductive age. The variables of importance of religion and frequency of church attendance were also included in the analysis. The study involved 5,530 reproductive age women in the (2006-2010) National Survey of Family Growth who indicate that they were ever married. Among the women who ever used NFP only 9.6 percent were currently divorced compared with the 14.4 percent who were currently divorced among the women who never used NFP (x (2) = 5.34, P NFP users the reason might be due to their religiosity. Lay summary: Providers of natural family planning (NFP) frequently mention that couples who practice NFP have fewer divorces compared to couples who use contraception. Evidence for this comment is weak. This study utilized a large data set of 5,530 reproductive age women to determine the influence that contraception, sterilization, abortion, and NFP has on divorce rates. Among the women participants who ever used NFP only 9.6 percent were currently divorced compared with the 14.4 percent who used methods of contraception, sterilization or abortion as a family planning method. Frequency of church attendance also reduced the likelihood of divorce.
Fehring, Richard J.
The purpose of this study was to determine the influence of contraception, abortion, and natural family planning (NFP) on divorce rates of US women of reproductive age. The variables of importance of religion and frequency of church attendance were also included in the analysis. The study involved 5,530 reproductive age women in the (2006–2010) National Survey of Family Growth who indicate that they were ever married. Among the women who ever used NFP only 9.6 percent were currently divorced compared with the 14.4 percent who were currently divorced among the women who never used NFP (x2 = 5.34, P NFP users the reason might be due to their religiosity. Lay summary: Providers of natural family planning (NFP) frequently mention that couples who practice NFP have fewer divorces compared to couples who use contraception. Evidence for this comment is weak. This study utilized a large data set of 5,530 reproductive age women to determine the influence that contraception, sterilization, abortion, and NFP has on divorce rates. Among the women participants who ever used NFP only 9.6 percent were currently divorced compared with the 14.4 percent who used methods of contraception, sterilization or abortion as a family planning method. Frequency of church attendance also reduced the likelihood of divorce. PMID:26912935
Wahyuni Apri Astuti
Full Text Available This study is carried out in Nusukan, Banjarsari, Surakarta. The problems that are related to economic crisis in Indonesia are the supply of contraception, the weakening of people purchasing power so they influence the realization of family planning program. The goals of the study are: to know the supply of contraception for poor household, to study the influence of the effect of economic crisis for the participant of family planning, to study the change of birth control and its effective strategy and to know the quality of family planning service. The data are collected using observation, and questionnaire. The study takes the area in which it has more productive couple, the percentage of poor families and the prosperous families I that belong to productive couple whose age 20 to 49 years old, at least they have two children, and participant of family planning or ever followed it. The result of the study shows that 82% respondents can get contraception easily before and at economic crisis. It is one of the important factors, for which the participant of family planning is still high. Although the economic crisis influences the price of contraception and family Income, it does not affect the participant of family planning. 87% respondents participate actively the family planning. This shows that the people have realized the importance of family planning program. There is an impact of economic crisis for the change of the ways of birth control. 38% respondents have changed over their strategy from modern to traditional contraception and the contrary, and from modern contraception to the other one. Some of them are abstention. The level of the people adaptation is high enough. They use various ways to prevent of being pregnant. 92% respondents do not want to be pregnant. If it happens an unwanted pregnancy, 15% of the respondents will abort their pregnancy. This is the challenge for the officers and the government to supply safe and accurate
... obligation to provide the employee with pension benefits? 1002.261 Section 1002.261 Employees' Benefits... and Benefits Pension Plan Benefits § 1002.261 Who is responsible for funding any plan obligation to provide the employee with pension benefits? With the exception of multiemployer plans, which have separate...
The role of family planning in achieving safe pregnancy for serodiscordant couples: commentary from the United States government's interagency task force on family planning and HIV service integration.
Mason, Jennifer; Medley, Amy; Yeiser, Sarah; Nightingale, Vienna R; Mani, Nithya; Sripipatana, Tabitha; Abutu, Andrew; Johnston, Beverly; Watts, D Heather
People living with HIV (PLHIV) have the right to exercise voluntary choices about their health, including their reproductive health. This commentary discusses the integral role that family planning (FP) plays in helping PLHIV, including those in serodiscordant relationships, achieve conception safely. The United States (US) President's Emergency Plan for AIDS Relief (PEPFAR) is committed to meeting the reproductive health needs of PLHIV by improving their access to voluntary FP counselling and services, including prevention of unintended pregnancy and counselling for safer conception. Inclusion of preconception care and counselling (PCC) as part of routine HIV services is critical to preventing unintended pregnancies and perinatal infections among PLHIV. PLHIV not desiring a current pregnancy should be provided with information and counselling on all available FP methods and then either given the method onsite or through a facilitated referral process. PLHIV, who desire children should be offered risk reduction counselling, support for HIV status disclosure and partner testing, information on safer conception options to reduce the risk of HIV transmission to the partner and the importance of adhering to antiretroviral treatment during pregnancy and breastfeeding to reduce the risk of vertical transmission to the infant. Integration of PCC, HIV and FP services at the same location is recommended to improve access to these services for PLHIV. Other considerations to be addressed include the social and structural context, the health system capacity to offer these services, and stigma and discrimination of providers. Evaluation of innovative service delivery models for delivering PCC services is needed, including provision in community-based settings. The US Government will continue to partner with local organizations, Ministries of Health, the private sector, civil society, multilateral and bilateral donors, and other key stakeholders to strengthen both the policy and
Popp, Tierney K.; You, Hyun-Kyung
The mediating role of parental satisfaction in the relation between family involvement in early intervention service planning and parental self-efficacy was explored. Participants included families of children with disability or delay involved in early intervention (n = 2586). Data were examined upon entry into early intervention (T1) and at…
partners (4.9 children for men and 3.7 for women). ... in terms of partner approval and discussion were important in determining the role of husbands regarding the use of family planning methods by women, and on the fertility level of the family.
Bos, H.M.W.; van Balen, F.
The study assessed the extent to which children between eight and 12 years old in planned lesbian families in the Netherlands experience stigmatization, as well as the influence of protective factors (relationship with parents, social acceptance by peers, contact with children from other families
de Valk, H.A.G.
This paper examined the work and family plans of adolescents from five different ethnic origins. The way in which parents influence these plans was studied by using a representative sample of secondary school pupils (N = 52,000) in The Netherlands. Results showed that substantial proportions of
Center for Disease Control (DHEW/PHS), Atlanta, GA.
This report summarizes abortion information received by the Center for Disease Control from collaborators in state health departments, hospitals, and other pertinent sources. While it is intended primarily for use by the above sources, it may also interest those responsible for family planning evaluation and hospital abortion planning. Information…
International Planned Parenthood Federation, London (England).
Population growth trends and family planning activities in Africa, America, Asia, Europe, and Oceania are summarized in this booklet developed by the International Planned Parenthood Federation. Narrative information for each continent gives a resume of population growth trends, reasons for the trends, population problems, policy formation, family…
Eto, Kumi; Koch, Pamela; Contento, Isobel R.; Adachi, Miyuki
Objective: To examine associations between Theory of Planned Behavior variables and the family meal frequency. Methods: Fifth-through seventh-grade students (n = 236) completed a self-administered questionnaire in their classrooms. The relationships between Theory of Planned Behavior variables (intention, attitudes, subjective norms, and perceived…
Full Text Available A study conducted on eligible rural women who were unwilling to accept family planning methods revealed that many women were concerned about child survival and viewed children as a source of support in old age. Family size was usually decided by in-laws. Pressure from in-laws to have more children was significantly higher in families where the women were less educated or illiterate.
Hossain, M W; Khan, H T; Begum, A
This paper studies the effectiveness of "Jiggasha," an innovative communication approach for the promotion of family planning in Dhaka, Bangladesh. Data from the 1996 Jiggasha follow-up survey were used, which gathered information by interviewing a network sample of 1862 married women and a subsample of 608 men. The study used the sample constituted by women respondents and included data on socioeconomic and demographic characteristics of the respondents and their knowledge, attitude and practice relating to contraceptives. Findings showed that Jiggasha respondents have more access to radio than television. All respondents reported having a radio in their homes and they emphasized the importance of broadcasting more family planning messages via both electronic media. Only 16% of the women in the study setting were exposed to group meetings. Of the respondents reporting participation in group meetings, 38.25% joined in a Jiggasha meeting, 23.15% in a Grameen Bank group meeting, and 4.70% in a Bangladesh Rural Advancement Committee group meeting. Logistic regression analysis indicated more access to Jiggashas among women over 30 years of age than among the younger age groups. Religion and education levels of respondents have significant impact on access to Jiggashas. Husbands' approval plays an important role among the Jiggasha respondents in using family planning method. This study provides important information for policy-makers to make family planning program a success.
The government of Sri Lanka will give a minimum bonus of SRs 100 ($US6.00) to anyone voluntarily being sterilized. Women will be given 7 days leave and men 3. Many public and private corporations pay sterilization bonuses; the new bonus was set to compete with generous maternity benefits. The average daily wage is about SRs 120. Currently the demand for sterilization is greater than the health services' ability to meet it. Depo-provera is becoming increasingly popular in Sri Lanka, especially among the Muslim communities. The Family Planning Association of Sri Lanka is to test new forms of social marketing of contraceptives to provide wider coverage through community-based distribution. One system will use the route of a commercial firm, Reckitt and Coleman Ltd., and another system will use a network of provincial organizers, commission agents, and local retailers. To create an awareness in young people of their responsibility toward society the Family Planning Association organized an orchid cultivation and family planning propaganda project. 40 young boys are being taught orchid culture and the benefits of family planning. Orchids can be grown in the back yard without any capital investment. There is a steady market for the orchids, and the training program lasts 6 months for each cohort of boys.
. Results: Overall, variation in postpartum use of modern contraception was not affected over the years by age or marital status. One contrast to this is in Ethiopia, where the data show a significant increase in uptake of postpartum contraception among adolescents from 2005 to 2011. There are systematic and pervasive equity issues in the use of modern postpartum family planning by education level, place of residence, and wealth quintile, especially in Ethiopia where the gaps are very large. Disaggregation of data also point to significant sub-national variations. After adjusting for socio-economic variables, the most consistent health sector services associated with modern postpartum contraception are institutional childbirth and child immunisation. ANC is less likely to be associated with the use of modern postpartum family planning. Conclusion: Postpartum use of modern family planning has remained very low over the years, including for childbearing adolescents. Our results indicate that improving postpartum family planning requires policies and strategies to address the inequalities caused by socio-economic factors and the integration of family planning with maternal and newborn health services, particularly with childbirth in facilities and child immunisation. Scaling up systematic screening, training of providers, and generation of demand are some possible ways forward.
Hounton, Sennen; Winfrey, William; Barros, Aluisio J D; Askew, Ian
contraception was not affected over the years by age or marital status. One contrast to this is in Ethiopia, where the data show a significant increase in uptake of postpartum contraception among adolescents from 2005 to 2011. There are systematic and pervasive equity issues in the use of modern postpartum family planning by education level, place of residence, and wealth quintile, especially in Ethiopia where the gaps are very large. Disaggregation of data also point to significant sub-national variations. After adjusting for socio-economic variables, the most consistent health sector services associated with modern postpartum contraception are institutional childbirth and child immunisation. ANC is less likely to be associated with the use of modern postpartum family planning. Postpartum use of modern family planning has remained very low over the years, including for childbearing adolescents. Our results indicate that improving postpartum family planning requires policies and strategies to address the inequalities caused by socio-economic factors and the integration of family planning with maternal and newborn health services, particularly with childbirth in facilities and child immunisation. Scaling up systematic screening, training of providers, and generation of demand are some possible ways forward.
Full Text Available Most studies reporting ethnic disparities in the quality of healthcare come from developed countries and rely on observational methods. We conducted the first experimental study to evaluate whether health providers in Peru provide differential quality of care for family planning services, based on the indigenous or mestizo (mixed ethnoracial ancestry profile of the patient. In a crossover randomized controlled trial conducted in 2012, a sample of 351 out of the 408 public health establishments in Metropolitan Lima, Peru were randomly assigned to receive unannounced simulated patients enacting indigenous and mestizo profiles (sequence-1 or mestizo and then indigenous profiles (sequence-2, with a five week wash-out period. Both ethnic profiles used the same scripted scenario for seeking contraceptive advice but had distinctive cultural attributes such as clothing, styling of hair, make-up, accessories, posture and patterns of movement and speech. Our primary outcome measure of quality of care is the proportion of technical tasks performed by providers, as established by Peruvian family planning clinical guidelines. Providers and data analysts were kept blinded to the allocation. We found a non-significant mean difference of -0.7% (p = 0.23 between ethnic profiles in the percentage of technical tasks performed by providers. However we report large deficiencies in the compliance with quality standards of care for both profiles. Differential provider behaviour based on the patient's ethnic profiles compared in the study did not contribute to deficiencies in family planning outcomes observed. The study highlights the need to explore other determinants for poor compliance with quality standards, including demand and supply side factors, and calls for interventions to improve the quality of care for family planning services in Metropolitan Lima.
Gleason, Melanie; Cicutto, Lisa; Haas-Howard, Christy; Raleigh, Bridget M; Szefler, Stanley J
Asthma is one of the most common illnesses of school-aged children and can lead to both health and educational disparities. Children from low socioeconomic backgrounds and racial/ethnic minorities suffer the greatest impact. They often lack the asthma self-management skills to successfully monitor, navigate, and negotiate appropriate asthma care. School settings are a strategic point of contact for this additional support. School nurses can monitor for signs of asthma worsening, manage symptoms, provide care coordination, and reinforce self-management skills. Likewise, school-based asthma programs have the potential to reduce health and educational disparities, but it is the strong linkage to the asthma care provider that is critical to successful school-based asthma management. Healthcare providers are encouraged to establish partnerships with families through patient-centered care and schools through clear communication and care coordination to ensure asthma is well controlled so the child is in school and ready to learn.
Jirapongsuwan, Ann; Latt, Kyaw Thu; Siri, Sukhontha; Munsawaengsub, Chokchai
A cross-sectional study was undertaken to investigate family planning (FP) practices and associated factors among reproductive-age married women. Data were collected by interviewing the 300 married women living in a rural area of Myanmar. The questionnaire had reliability coefficients ranging from .8 to .9. Results indicated that 73.3% of women performed FP, and contraceptive injection was the most common method. Significant associations were found with age 21 to 35 years (adjusted odds ratio [adj OR] = 3.748, 95% CI = 2.179-6.445), adequacy of income (adj OR = 2.520, 95% CI = 1.477-4.290), good attitude toward FP (adj OR = 0.386, 95% CI = 0.228-0.656), good support from health care providers (adj OR = 0.129, 95% CI = 0.054-0.313), good support from family (adj OR = 0.304, 95% CI = 0.163-0.565), good support from friends (adj OR = 0.344, 95% CI = 0.193-0.613), and FP practice. It is recommended that designing FP programs with peers and family involvement could increase the practice of FP among rural Myanmar women. © 2016 APJPH.
Rohland Barbara M
Full Text Available Abstract Background The epidemiology of obesity in primary care populations has not been thoroughly explored. This study contributes to filling this gap by investigating the relationship between obesity and different sources of personal stress, mental health, exercise, and demographic characteristics. Methods A cross-sectional survey using a convenience sample. Five hundred women who attended family planning clinics were surveyed and 274 provided completed answers to all of the questions analyzed in this study. Exercise, self-rated mental health, stress, social support, and demographic variables were included in the survey. Multiple logistic regression analysis was performed. Results After adjusting for mental health, exercise, and demographic characteristics of subjects, analysis of the data indicated that that being having a large family and receiving no support from parents were related to obesity in this relatively young low-income primary care sample, but self-reported stress and most types of social support were not significant. Conclusion Obesity control programs in primary care centers directed at low-income women should target women who have large families and who are not receiving support from their parents.
Willyane de Andrade Alvarenga
Full Text Available During and after pregnancy, mothers with HIV can undergo treatment that is capable of preventing vertical transmission (VT to their babies. The purpose of this study was to analyze the experience of family members that provide care for children whose mothers have HIV, to reduce the risk of VT, with emphasis on the beginning of this trajectory. This study was based on the qualitative approach and Symbolic Interactionism was adopted as a theoretical framework. A total of 36 family members participated in the study, all of whom were carers of children aged up to 18 months and waiting for confirmation of the HIV diagnosis. Data were collected in a hospital in north-eastern Brazil, between December 2012 and February 2013, and examined by means of content analysis. Child care began during pregnancy, when the possibility of the child having HIV was expected. Some had previous experience in providing care for exposed children. Understanding the early trajectory of care will help find ways to provide better support for carers during the trajectory of diagnosis confirmation.
Herson, J; Crocker, C L; Butts, E; Phong, L T; Haynes, J A
The management information system (FP/MIS) used by the Howard University Center for Family Planning Services, which operates community family planning clinics in Washington, D.C. is described. The system was developed to satisfy program objectives in patient management, program planning and evaluation, resource management, federal reporting systems and clinical, epidemiological and health services research. The data collection forms used in the system and the output from the four data display groups--patient profile, resource management, quality of care and epidemiology-are described along with examples of their use.
With community mobilization, the women acceptance and attitude to modern methods of contraception was better than previously. Prior to community mobilization, 13 out of 30 women in need of permanent limitation of their family size chose injectable contraceptives. With community mobilization, majority of the women (120 ...
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.
Full Text Available Background: In recent years use of family physicians has been determined as a start point of health system reform to achieve more productive health services. In this study we aimed to assess the cost-efficiency of the implementation of this plan in Fars province, southern Iran.Methods: This cross-sectional descriptive study was done in 2007 in 18 provincial health centers as well as 224 rural health centers in Fars province. Data were collected using forms, statistics, and available evidence and analyzed by expert opinion and ratio techniques, control of process statistics, and multi indicator decision model.Results: Although in the family physician plan more attention is paid to patients and the level of health training, availability, and equity has improved and the best services are presented, it has not only decreased the costs, but also increased the referrals to pharmacies, laboratories, and radiology clinics and the costs of healthcare.Conclusion: Although the family physician plan has led to more regular service delivery, it has increased the patients’ referral to pharmacies, laboratories, and radiology centers and more referrals to family physicians. It seems that the possibility of setting regularity in health system can be gained in the following years of the family physician program mainly via planning, appropriate management and organizing correct health plans according to need assessments, and continual supervision on activities, which would happen according to current experiences in this plan.
Full Text Available Marisa I Echenique,1 Rachel S Bookman,1 Violeta J Rodriguez,1 Richard P LaCabe,1 JoNell Efantis Potter,2 Deborah L Jones1 1Department of Psychiatry and Behavioral Sciences, 2Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, Miami, FL, USA Abstract: Once expected to not survive childhood, youth with perinatally acquired HIV (YPHIV have now reached young adulthood and are of reproductive age and sexually active. Given the health impact of pregnancy among YPHIV, understanding reproductive decision making may inform preconception counseling strategies. Most literature regarding reproductive health among YPHIV focuses on women, overlooking one of the most important factors influencing the reproductive decision-making process, male sexual partners. This study examined attitudes, perceptions, and experiences of young men with perinatally acquired HIV (YMPHIV regarding family planning and relationships, safer sex, disclosure, stigma, and psychological health. Participants (n=21 were YMPHIV aged 18–24 years recruited in Miami, Florida. Focus groups (n=4 were conducted; qualitative data were analyzed using grounded theory. HIV disclosure, stigma, fertility intentions, safer preconception knowledge, attitudes and practices, family planning communication with medical providers and family, and mental health emerged as themes. Results suggest that despite accurate knowledge regarding healthy preconception practices, psychopathology, substance use, and stigma impact the uptake of HIV health care interventions. Effective interventions on preconception counseling may require more tailored approaches than knowledge-based psychoeducation alone, such as inclusion of psychological treatment, which could be offered in HIV health care settings to optimize health outcomes. Keywords: preconception counseling, fertility decision making, young adults, HIV risk reduction, HIV knowledge
Esmundo, R A
The potential effect of the 1991 Local Government Code on the Philippine Family Planning Program (PFPP) and the consequent complete devolution of certain basic services to the Local Government Units (LGUs) is analyzed. The Technical Secretariat (TS) started its operations in august 1990. Sitios or settlements make up a barangay and a number of barangays comprise a municipality or town in a province, or district in a city. The University of the Philippine Population Institute estimates that each barangay has between 80 to 120-150 women of reproductive age. There are also a total of some 746,00 potential village-based volunteers. The annual increase of the population is about 1.3 million, and in 1992 the country had a little over 63 million people. Considering 15% of them as married women of reproductive age (MCRAs) there will be about 9.5 million MCRAs plus about 6.1 million adolescents or a total target population of 15.7 million women of reproductive age (WRA). The principles of safe motherhood and child survival call for providing quality maternal and child health/family planning service to as many WRAs as possible each year, besides freedom of choice and referral. The information, education, and communication activities are of particular importance. LGUs will determine the role of the nongovernmental organizations (NGOs) in the PFPP from 1992 onward. The concerned organizations, the devolved line agencies of government, the NGOs, the commercial sector, social marketing agencies and TS/PFPP are responsible for planning and managing the program to assist the LGUs in developing their own programs.
A case scenario for training of family planning (FP) managers in developing countries and for group discussion follows. A clinic director had learned that two FP programs in another part of the country worked with community members to promote their goals. In one, a manager of a food processing company organized weekly discussions about FP and reproductive health during lunch. The number of factory workers using contraception increased from 12-25%. The director returned to her clinic with plans to recruit influential male community leaders. If she could use male volunteers, she would not need to worry about resources to recruit, hire, and train new people for IEC activities. In her region, awareness of and access to FP were among the lowest countrywide. Less than 50% of men knew about condoms in her region, while more women knew about FP methods. She thought that if males knew more about the benefits of FP, they would support their wives' interest in FP. Increased FP knowledge would likely result in better reproductive health practices and prevention of sexually transmitted diseases (STDs), which are prevalent in her region. She invited 8 male leaders to a meeting with 2 IEC outreach workers. The first meeting revolved around the benefits their participation would bestow on the program and community. The men were quite interested. During the second meeting, they examined the objectives of the FP program and produced their own goals. To help the program increase use of family planning methods 5%, the men aimed to increase knowledge of FP and STDs among males and to increase the number of condoms distributed through the program 2-fold in the first year. They wanted to involve other community males. The Ministry would provide condoms if a condom distribution system could be set up and some men suggested that males be trained to distribute condoms. Case discussion questions follow the scenario: e.g., How can community participation benefit the community and the FP
William B Brinkman
Full Text Available William B Brinkman, Jeffery N EpsteinDepartment of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USABackground: Attention-deficit/hyperactivity disorder (ADHD is a common condition that often results in child and family functional impairments. Although there are evidence-based treatment modalities available, implementation of and persistence with treatment plans vary with patients. Family preferences also vary and may contribute to variability in treatment utilization.Objective: The objective of this study is to describe the evidence-based treatments available for ADHD, identify patterns of use for each modality, and examine patient and parent treatment preferences.Method: Literature review.Results: Treatment options differ on benefits and risks/costs. Therefore, treatment decisions are preference sensitive and depend on how an informed patient/parent values the tradeoffs between options. Literature on patient and parent ADHD treatment preferences is based on quantitative research assessing the construct of treatment acceptability and qualitative and quantitative research that assesses preferences from a broader perspective. After a child is diagnosed with ADHD, a variety of factors influence the initial selection of treatment modalities that are utilized. Initial parent and child preferences are shaped by their beliefs about the nature of the child's problems and by information (and misinformation received from a variety of sources, including social networks, the media, and health care providers. Subsequently, preferences become further informed by personal experience with various treatment modalities. Over time, treatment plans are revisited and revised as families work with their health care team to establish a treatment plan that helps their child achieve goals while minimizing harms and costs.Conclusions: Studies have not been able to determine the extent to which
Elmusharaf, Khalifa; Byrne, Elaine; O'Donovan, Diarmuid
Understanding what determines family size is crucial for programmes that aim to provide family planning services during and after conflicts. Recent research found that development agents in post conflict settings do not necessarily take time to understand the context adequately, translate their context understanding into programming, or adjust programming in the light of changes. South Sudan, a country that has been suffering from war for almost 50 years, has one of the highest maternal death rates and the lowest contraceptive utilization rates in the world. This research used Participatory Ethnographic Evaluation and Research (PEER) to provide a contextualised understanding of social and traditional practices and their implications for family planning. Fourteen women were recruited from 14 villages in Renk County in South Sudan in the period 2010-2012. They were trained to design research instruments, conduct interviews, collect narratives and stories and analyse data to identify, prioritize and address their maternal health concerns. As a result of wars, people are under pressure to increase their family sizes and thus increase the nation's population. This is to compensate for the men perished in war and the high child death rates. Large family size is regarded as a national obligation. Women are caught up in a vicious cycle of high fertility and a high rate of child mortality. Determinants of large family size include: 1) Social and cultural practices, 2) Clan lineage and 3) Compensation for loss of family members. Three strategies are used to increase family size: 1) Marry several women, 2) Husbands taking care of women, and 3) Financial stability. Consequences of big families include: 1) Financial burden, 2) Fear of losing children, 3) Borrowing children and 4) Husband shirking responsibility. The desire to have a big family will remain in South Sudan until families realise that their children will live longer, that their men will not be taken by the war
Abbas, Khadija; Khan, Adnan Ahmad; Khan, Ayesha
The public sector provides a third of family planning (FP) services in Pakistan. However, these services are viewed as being underutilized and expensive. We explored the utilization patterns and costs of FP services in the public sector. We used overall budgets and time allocation by health and population departments to estimate the total costs of FP by these departments, costs per woman served, and costs per couple-year of protection (CYP). The public sector is the predominant provider of FP to the poorest and is the main provider of female sterilization services. The overall costs of FP in the public sector are USD 55 per woman served, annually (USD 17 per CYP). Within the public sector, the population welfare departments provide services at USD 72 per woman served, annually (USD 17 per CYP) and the health departments at USD 39 per woman per year (USD 29 per CYP). While the public sector has a critical niche in serving the poor and providing female sterilization, its services are considerably more expensive compared to international and even some Pakistani non-government organization (NGO) costs. This reflects inefficiencies in services provided, client mistrust in the quality of services provided, and inadequate referrals, and will require specific actions for improving referrals and the quality of services.
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.
Yokota, Mariko; Tsunawaki, Shinji; Narumoto, Keiichiro; Fetters, Michael D
Even though Japan faces serious challenges in women's health care such as a rapidly aging population, attrition of obstetrical providers, and a harsh legal climate, few family medicine residency training programs in Japan include training in obstetrics, and the literature lacks research on women's views of intra-partum pregnancy care by family physicians. In this exploratory study, we conducted semi-structured qualitative interviews with five women who received their admission, intrapartum, delivery and discharge care from family medicine residents in the obstetrics ward of a community training hospital. Four women had vaginal births, and one had a Cesarean section. Three were primiparous, and two multiparous. Their ages ranged from 22-33. They found value in family physician medical knowledge and easy communication style, though despite explanation, some had trouble understanding the family physician's scope of work. These women identified negative aspects of the hospital environment, and wanted more anticipatory guidance about what to expect physically after birth, but were enthusiastic about seeing a family doctor after discharge. These results demonstrate the feasibility of family medicine residents providing inpatient birth care in a community hospital, and that patients are receptive to family physicians providing that care as well after discharge. Women's primary concerns relate mostly to hospital environment issues, and better understanding the care family physicians provide. This illustrates-areas for family physicians to work for improvements.
Inaoka, E; Wakai, S; Nakamura, Y; Al Babily, Y; Saghayroun, A A
Contraceptive discontinuation has been an important issue in low contraceptive prevalence countries like Yemen. Religious and cultural factors might play a large role in barriers against contraceptive acceptance. This study revealed the characteristics of women who accepted contraception and the factors related to the regularity of visits to a clinic in Yemen. Women perceived that accepting contraception was against neither Islam nor their husband's attitudes. They rather paid attention to mother and child health. Regularity of visits was not related to socioeconomic or demographic factors, but was related to satisfaction with family planning services. This implies that different approaches are needed to promote 'continuation' and 'regular visits'. A population policy which promotes birth spacing for maternal health in accordance with cultural contexts should be an effective and acceptable strategy in Yemen. Regular visits could be prompted by increasing the quality of services, including communication between clients and providers about side-effects and alternative choices of methods.
Hodge, Lauren M; Turner, Karen M T; Sanders, Matthew R; Forster, Michell
This paper evaluates program, workplace and process factors associated with implementation and sustainment of an evidence-based parenting support program (EBP) in disadvantaged communities. Correlation analyses and binary logistic regressions were used to assess the associations between key implementation support factors and program implementation (at 18 months) and sustainment (at 36 months) post training with (N=35) Australian Aboriginal and Torres Strait Islander family support providers using the Triple P - Positive Parenting Program in Indigenous child protection agencies. This study demonstrated that for implementation at 18 months, there was a trend for implementing providers to report higher levels of partnership support, perceived program benefit, workplace support and workplace cohesion. However, the only significant relationship was with partnership support (r=.31 pprogram implementation. For sustained implementation at 36 months, no relationship was found between sustainment and program characteristics, workplace characteristics, supervision and peer support or sustainability planning. Supportive coaching was the only significant correlate (r=0.46, pp=0.009] in the program sustainment model. Overall, these findings suggest the need for further exploration of program and workplace variables and provide evidence to consider incorporating partnership support and supportive coaching in real world implementation models to improve the likelihood of EBP implementation and sustainment in Indigenous communities. Copyright © 2017 Elsevier Ltd. All rights reserved.
Full Text Available Post-abortion family planning (PAFP has been proposed as a key strategy to decrease unintended pregnancy and repeat induced abortions. However, the accessibility and quality of PAFP services remain a challenge in many countries including China where more than 10 million unintended pregnancies occur each year. Most of these unwanted pregnancies end in repeated induced abortions. This paper aims to explore service providers' perceptions of the current situation regarding family planning and abortion service needs, provision, utilization, and the feasibility and acceptability of high quality PAFP in the future. Qualitative methods, including in-depth interviews and focus group discussions, were used with family planning policy makers, health managers, and service providers. Three provinces-Zhejiang, Hubei and Yunnan-were purposively selected, representing high, medium and relatively undeveloped areas of China. A total of fifty-three in-depth interviews and ten focus-group discussions were conducted and analysed thematically. Increased numbers of abortions among young, unmarried women were perceived as a major reason for high numbers of abortions. Participants attributed this to increasing socio-cultural acceptability of premarital sex, and simultaneously, lack of understanding or awareness of contraception among young people. The majority of service stakeholders acknowledged that free family planning services were neither targeted at, nor accessible to unmarried people. The extent of PAFP provision is variable and limited. However, service providers expressed willingness and enthusiasm towards providing PAFP services in the future. Three main considerations were expressed regarding the feasibility of developing and implementing PAFP services: policy support, human resources, and financial resources. The study indicated that key service stakeholders show demand for and perceive considerable opportunities to develop PAFP in China. However, changes
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China's State Counselor and Minister of the State Family Planning (FP) Commission is reported to have made suggestions on improving FP effectiveness to officials in Qianshan and Jinzhai counties of Anhui Province, in Hongya and Mingshan counties of Sichuan Province, and in Dezhau Prefecture and Tai'an City of Shandong Province. In Anhui Province, Minister Peng Peiyun emphasized the importance of FP at the grassroots level and the responsibility of providing education, publicity, and contraceptive services to each couple of childbearing age. Publicity is needed to popularize the advantages and necessity of deferred marriage, deferred childbearing, fewer and healthier births, and gender equality. In Sichuan, Minister Peng state that FP is important for economic development. Other benefits are an improved standard of living, an improvement in women's social status, the formation of healthier and happier families, and improvement in the quality of human resources. Minister Peng stressed that social reform could change existing habits and customs. Publicity should be specific to conditions in each province and include information on how to increase family income, scientific production skills, and good child-rearing practices. Contraceptive services should be available in every village, and quality must be improved. This means wider contraceptive choices, more concern for the day-to-day problems of families with one daughter, and improved training of FP technicians to increase safety and reliability. In Shandong Province, Minister Peng urged that quotas be retained, but the pressure should be reduced on subordinating departments. Targets for FP implementation can be attained when major departments cooperate with those on grass roots level. Requirements must be practical. All couples should be permitted to bear a second child after a birth interval of several years. Program quality can be improved by upgrading worker's skills and building a large group of qualified FP