Family Planning Attitudes Research Articles

The Delivery and Use of Contraceptive Services in Rural Tunisia

This article summarizes a 1981 report published by the National Family Planning and Population Office an agency of the Ministry of Public Health of Tunisia. The report provides insights into the fertility and contraceptive behavior of rural Tunisian women and the problems that they face in obtaining family planning services as well as implications for future programs. The report examines family planning attitudes and practice contraceptive availability and accessibility and the unmet demand for family planning in 1 of Tunisias 21 administrative regions the province of Jendouba. The results of 2 special studies are presented here: the 1979 Contraceptive Prevalence Survey a representative sample of 1827 currently married women aged 15 to 49 living in Jendouba; and a 2 1/2 year pilot community based experiment known as Family Planning for Rural Couples (PFPC) which was designed to increase contraceptive availability and use among rural families in 1/2 of the province. 2 most significant findings are the substantial unmet demand for family planning and the inaccessibility of traditional service outlets for the majority of the provinces rural women. Contraceptive users and nonusers alike reported that it was difficult to get to a family planning service provider. The largely urban based health facilities in Jendouba have not adequately met the family planning needs of women living in widely scattered settlements particularly those interested in obtaining the pill and barrier methods. The PFPC outreach experiment provided a low cost nonclinical service delivery model for rural Tunisia that would increase availability and accessibility of family planning services. Results confirm that when contraceptives are distributed at the household and community levels there can be a dramatic initial increase in new acceptor rates. However the pilot project also demonstrates that effective referral mechanisms and permanent resupply points in the community together with sustained information and education activities are essential in order to achieve and maintain high levels of contraceptive use. (authors modified) (summary in FRE)

Multivariate relationships between modernity value orientations and family planning indicators

Using canonical correlation techniques in the analysis of data collected from interviews with 1,737 married women of three Indian states, this paper evaluated three modernity value orientations—subjective efficacy, openness to change, and propensity to plan—as predictors of a set of four family planning indicators. The analysis revealed that, in Haryana, both subjective efficacy and openness to change were related to family planning knowledge and attitudes as well as to favorability toward small family size. Propensity to plan was related to adoption. In rural Tamil Nadu, subjective efficacy and openness to change were related essentially to family planning attitudes, whereas in urban Tamil Nadu they were strongly related to adoption. In the latter area, the best linear association between the modernity variables (predictor set) and the family planning variables (criterion set) resulted when the criterion set was so weighted that it involved a large amount of adoption and a moderate amount of contraceptive knowledge and attitudes. Thus, in urban Tamil Nadu, the four family planning variables seemed to cohere, reflecting cognitive, attitudinal, and behavioral consistency. Except in Meghalaya, it appears that married women with higher subjective efficacy, openness to change, and planning tendency may be more likely than others to translate their family planning knowledge and favorability toward small family size into action, under suitable conditions. Some of the implications of the findings are discussed.

Contraceptive Acceptability Research: Utility and Limitations

Acceptability studies employing attitudinal and/or behavioral variables have inspired semantic controversies and confusion. The limits of acceptability studies are reviewed using Mexican attitudinal studies as examples. Mexican attitudinal studies are classified according to 3 types; hypothetical methods and attributes of methods; methods in clinical trials; and culturally based attitudes. In 2 studies of family planning and method attitudes fears of infidelity and female liberation were voiced in the group session but not shown in the survey questions designed to evoke those fears. Attitudes ascertained were partially a function of the methodology employed. Behavioral studies are limited in that they depict acceptability under special not normal circumstances e.g. free sample studies comparative field trials and free choice studies. Prediction is justifiable only if study conditions continue unchanged in the real world. Attitudinal studies are better used to understand the reasons for peoples evaluations instead of predicting acceptability.

Family planning knowledge, attitude and practice in the rural areas of Sarawak

SummaryA survey of 1056 married women living in rural areas of Sarawak showed that 86% of them of had knowledge of family planning and 85% expressed a favourable attitude towards it. Of the total sample, 46% were using some form of contraception; the pill was the most popular method and was used by 76% of the women practising contraception. The present average family size in rural sarawak is 5·3 and greater family planning programme effort will be needed if this is to be reduced, especially in view of the social and cultural factors involved and the generally low educational standard of the women

Health Planning and Population Policy in Africa

Despite common interests, health planners and population planners have apparently different objectives: respectively to improve health and reduce mortality, and to reduce rapid rates of population growth. To the extent that reductions in mortality increase population growth, the objectives appear contradictory. seeming contradiction has been heightened by demographic evidence that post-war rapid population growth in developing countries was largely the result of public health measures which suddenly lowered mortality rates. Population and health planners have agreed on family planning as a common program where their objectives converge, since family planning both reduces births and improves the mother's and already-born children's health. However, one school of thought in the population field maintains that the solution to the population problem lies not soley in family where the health and welfare of the family are the motivating force, but in measures beyond family planning, where concern with economic development and societal welfare are paramount. beyond-family-planning school maintains that individuals want more children than the larger society can afford, that family planning permits the planning of families which are too large. They assert that, in addition to family changes are required in tax structure, housing policy, and female employment strategies if childbearing is to be discouraged (Davis, 1967; Berelson, 1969). premise of this essay is that, despite the apparent contradiction, those in the population field should give priority to improving health standards and reducing mortality in Africa. In Africa, cultural, social, and political constraints militate against a strong public commitment to population limitation. Studies of the public's attitude toward family size (Knowledge, Attitude, and Practice of Family Planning, commonly called KAP studies) have repeatedly demonstrated that African parents do not have more children than they want (Caldwell, 1968 and 1974).1 In fact, recent evidence suggests the possibility that some African parents have fewer children than they desire, because of subfecundity caused by nutritional and general health problems (McCabe, 1975). African governments at the 1974 World Population Conference in Bucharest generally took the position that population should not be treated as an issue per se, that The Best Pill is Development (Pradervand, 1973b).2 At present, only Ghana and Kenya have policies favoring less rapid growth of population; Nigeria, Tanzania, and others promote family planning on the grounds of health; some countries, such as Cameroon, Gabon, and the Ivory Coast, actively favor more rapid growth (Gwatkin, 1972).

Some Aspects of Health Care in Rural Nigeria

1973 and 1974 surveys of Ibo women of childbearing age were undertaken in order to obtain baseline information for developing a community health program. Findings from the village of Ebendo show extremely high fertility rates and infant and maternal mortality levels as well as high desired family size. An examination of the traditional health care and family planning attitudes suggests that a health program offering family planning services in this region should consider offering subfertility counseling; providing services free or nearly free; and focusing on the younger women who are more receptive to family planning.

Family planning knowledge, attitudes, and practice in Malaya

Several policy decisions can be drawn from the brief discussion presented in this paper. First, knowledge of birth control was rather meager among the uneducated, the poor, and the rural folk, and therefore family planning education should be encouraged and intensified to impart this basic knowledge to these categories of women in particular. Second, there was overwhelming approval of the idea of family planning as well as ardent interest in learning more about it among women in all socio-economic strata. This means that immediate implementation of family planning practice is more urgent and necessary than pursuasion to the idea itself. Vital prerequisite attitudes favorable to the initiation of a nation-wide action program are already in existence. Third, the use of birth control was very limited, but there is widespread desire on the part of married women to limit their family size. It is thus the duty of the Board and the F.P.A. to satisfy their needs by providing adequate family planning services, which should preferably be offered on a priority basis so that those who require them most are provided service first.

Pakistan's Administrative Approach for a Family Planning Program

This paper deals with the organization and administration of the Pakistani family planning pattern. The need for control of population growth in Pakistan is urgent. The urgency of the problem recognized in the second 5-year plan implemented in 1960-1965 forced the Government of Pakistan to establish a family planning program. The program was entrusted to the National Family Planning Council an autonomous agency with a full-time commissioner of family planning. The health minister is chairman of the Council and the commissioner is its secretary. The commissioner is also joint secretary (the second highest rank in the civilian administration) to the Government of Pakistan in the new division of family planning in the Ministry of Health Labour and Social Welfare. The National Family Planning Council is responsible for policy and implementation of the family planning scheme including coordination assessment and evaluation of activities research foreign aid and consultation. The National Council has an evaluation unit for each province with a technical staff to assess the progress and success of the program. Each unit has an administrator medical officer health educator statistician interviewers and clerical staff . Performance is measured in terms of quantity such as number of perso nnel on the job IUD insertions and amount of conventional contraceptives sold. The progress of the program is also followed through a continuous national-sample survey on knowledge attitude and practice of family planning. Fertility pattern studies reveal long-term use of various methods. The aim for the third 5-year plan 1966-1970 is to reduce the crude birthrate by 20% from 50 to 40 per 1000. Goals were set for each district based on the number of fertile females in the population available help and local conditions. The benefits of an independent government agency are chiefly in expediting the start of a national family planning program. A plan was formulated a budget prepared and personnel recruited in about 3 months in Pakistan. Much government red tape such as salary scales civil service lists and multiple approvals was circumvented. (AUTHORS MODIFIED)