Family Planning Program Activity Research Articles

Association of men's exposure to family planning programming and reported discussion with partner and family planning use: The case of urban Senegal.

BackgroundFamily planning programs increasingly aim to encourage men to be involved in women’s reproductive health decision-making as well as support men to be active agents of change for their own and the couple’s reproductive health needs. This study contributes to this area of work by examining men’s exposure to family planning (FP) program activities in urban Senegal and determining whether exposure is associated with reported FP use and discussion of family planning with female partners.MethodsThis study uses data from two cross-sectional surveys of men in four urban sites of Senegal (Dakar, Pikine, Guédiawaye, Mbao). In 2011 and 2015, men ages 15–59 in a random sample of households from study clusters were approached and asked to participate in a survey about their fertility and family planning experiences. These data were used to determine the association between exposure to the Initiative Sénégalaise de Santé Urbaine (in English: Senegal Urban Reproductive Health Initiative) family planning program interventions with men’s reported modern family planning use and their reported discussion of FP with their partners. Since data come from the same study clusters at each time period, fixed effects methods at the cluster level allowed us to control for possible program targeting by geographic area.ResultsMultivariate models demonstrate that religious leaders speaking favorably about family planning, seeing FP messages on the television, hearing FP messages on the radio, and exposure to community outreach activities with a FP focus (e.g., house to house and community religious dialogues) are associated with reported modern family planning use and discussion of family planning with partners among men in the four urban sites of Senegal.ConclusionsThis study demonstrates that it is possible to reach men with FP program activities in urban Senegal and that these activities are positively associated with reported FP behaviors.

Global Trends in Family Planning Programs, 1999-2014.

Since 1972, the Family Planning Effort Index has measured national family planning program activities in developing countries and provided a longitudinal perspective on a standardized set of program characteristics. In 2014, experts in 90 developing countries assessed national family planning program effort in four main component areas-policies, services, monitoring and evaluation mechanisms, and access to methods-using a standardized questionnaire. Results were compared with previous years' data. Globally, family planning program effort has progressed in all four main component areas. The service component, historically the weakest, was rated lowest of all components in 2014, at 47% of the maximum effort, despite a marked improvement of 7.6 percentage points since 1999. Policies, generally the strongest component, remained the strongest in 2014, with 55% of the maximum score and a 6.7 percentage-point improvement since 1999. Monitoring and evaluation improved the most, by 7.8 percentage points, from 45% to 53%, while access improved more modestly, by 2.7 points, from 49% to 52%. Family planning efforts were generally strongest in Asia and Oceania and generally weakest in Central Asia and Eastern Europe. Global family planning programs have improved consistently over the last few decades, although there is room for further development in all regions.

Fertility, Contraceptive Use and Family Planning Program Activity in the Islamic Republic of Iran

This study examined contraceptive prevalence in Iran modern method mix sources of supply unwanted pregnancy fertility and desire for small families. Data were obtained from KAP surveys conducted in 1989 and yearly during 1992-97 among about 10000 rural and 10000 urban women 15-49 years old. A demographic and health type survey is planned for 1999. The Islamic government increased commitment to family planning and small family size in the 1990s. Findings indicate that contraceptive prevalence increased from 37% to 65% during the 1970s to 1992. In 1997 66% of rural women and 77% of urban women were using contraception. The pill was the most popular method in 1992. About 43% of modern method use in urban areas and 64% in rural areas was the pill. 21% of modern method users in urban areas used the IUD. 18% of modern method users in rural areas had tubectomies. Condoms were 17% of modern method use by urban women and 10% by rural women. By 1997 pill use declined; tubectomy use increased. 57% of modern methods were obtained from public services. In 1996 many illiterate women chose tubectomy; a smaller proportion of illiterate men chose vasectomy. About 30% of pill users did not take the pill correctly. High parity pregnancies were more likely to be unwanted. Fertility in 1996 was 2.8 births/woman. Literacy in 1996 was 74% for women over 6 years old. Literacy for rural women was 62%.

Family Planning Operations Research and Program Evaluation Literature Review

A selected annotated bibliography of operations research and program evaluation articles and reports on family planning program activities in Pakistan from 1968-1993. Some thirty references are summarized including study design, methodology, and major findings.

The Impact of Family Planning Program Activity on Fertility

This study seeks to determine through multivariate areal analysis whether higher family planning program enrollment rates in local areas are associated with lower us fertility rates in 1980, when other factors are controlled statistically. The analyses do support the conclusion that programs have had an impact on aggregate fertility levels. Other data, taken from program records and from surveys of individual women, also indicate that the impact of the programs has been felt by large numbers of women have visited clinics and obtained contraceptive services. The areal analysis, made possible by the existence of data from the decennial census, suggests that this impact has been translated into measurably lower fertility rates among women, including poor women and teenagers, across the US. Higher enrollment rates were associated with lower fertility in every model in which prior fertility was controlled. Because the dispersion of the black population among counties is limited, the statistical power in areal analysis is much less for this segment of the population than for whites and for the total population. The strongest predictor of program enrollment in 1978 was the level of program activity, as measured by the number of family planning program sites.

The Impact of Development and Population Policies on Fertility in India

This article examines the impact of development and population policies on fertility decline and regional variations in India during the 1970s. Indicators of development at the household level include female literacy and education, infant mortality, and poverty; at the village level they include availability of such social services as schools, medical facilities, and transportation and communication facilities. Multiple regression analysis of data aggregated at the state level demonstrates that conditions conducive to fertility decline include high adult female literacy and low infant mortality as indicators of social development, and high contraceptive use and, to a lesser extent, high female age at marriage as proximate determinants of fertility. There are reasons to believe that India's national family planning program contributed to the decline in fertility observed since the 1960s. The pace of fertility decline in the future will depend upon the pace of infant mortality decline, enhancement in female education, and improvements in family planning programs.

Determinants of national family planning effort

In light of recent research demonstrating the substantial impact of family planning programs on fertility a multivariate model of the determinants of national differences in family program effort are estimated and developed. The framework that guides the specification of this model identifies three broad classes of factors--those that create demand for family planning those that facilitate the initiation and expansion of family planning programs and finally those that encourage or inhibit program development. The results from multiple regression using 84 less developed countries indicate that demand for family planning facilitating infrastructure and certain demographic and geographic factors are important determinants of program effort. These results suggest that popular demand for family planning is helpful but that policy makers must perceive the adverse consequences of high fertility and have the infrastructure necessary to develop an effective organized family planning program. Current U.S. policies relevant to reducing birth rates are found to reflect quite well research on determinants of fertility declines among less developed countries. Policies that affect the infrastructure and increase motivation for smaller families are those policies that generate activities that increase literacy public health economic well-being change traditional sex roles provide alternatives to traditional kinship domination of individual couple reproductive decisions and decrease the husbands authority over reproductive decisions. There are also policies which directly effect the implementation of population programs that reduce fertility. Policies affecting program development are those that specify what types of program activities are encouraged or discouraged. U.S. policy also balances the often competing claims of family planners and their opponents by encouraging support to both developmental projects as well as direct aid to family planning program activities. (authors modified)

Fertility and Family Planning in Haiti

This paper presents data on current levels and trends in fertility in Haiti and discusses some of the factors that determine the current situation. Particular attention is given to knowledge and use of contraception and the impact of the recently established national family planning program. The major source of data is the 1977 Haiti Fertility Survey, but more recent information on family planning program activities is also presented. Factors likely to influence future trends in fertility and family planning are presented in concluding.

Fertility and Family Planning in Rural Northern Thailand

From the mid-1960s to the mid-1970s, when fertility was declining in Thailand as a whole, especially rapid declines occurred in Northern Thailand, but they did not occur uniformly in all the region's provinces. The Northern Thailand Fertility Study, initiated in 1975 to study the reported fertility changes, gathered data in two provinces: Chiang Mai, where fertility decline has been quite rapid, and Chiang Rai, which experienced relatively little decline until 1974. This preliminary report discusses fertility levels and trends in the two provinces, fertility experience and expectations of respondents, attitudes toward and knowledge of family planning, and contraceptive practice. The results suggest that most of the difference in fertility decline is related to the different level of family planning program activity in the two provinces.Substantial declines in Thai fertility levels coincide with a marked increase in family planning activity, both public--the National Family Planning Program, announced in 1970--and private--e.g., McCormick Hospital Program, started in Chiang Mai in 1963. Regional and changwat (provincial) differentials in rate of fertility decline have been observed. In Chiang Mai changwat, for example, where efforts began in 1963, there has been a more rapid decline than in Chiang Rai, where family planning was introduced only in 1970. The Study of Social and Psychological Barriers to the Adoption of Family Planning in Rural Northern Thailand (The Northern Thailand Fertility Study, NTFS) was an attempt to identify the reasons for this differential and the relationship of family planning activities to fertility decline. A random sample was drawn from each of 190 rural villages chosen randomly from Chiang Mai and Chiang Rai. All ever-married women aged 15-44 and husbands of currently married women were interviewed from September 1976 to February 1977. Response rates were 88.5% of 1921 women and 80.5% of 1615 men. Interviewers were mostly students from Chiang Mai University, intensively trained and closely supervised. Substantial declines in age-specific fertility rates occurred in both changwats between 1968-1972 and 1973-1976, with the Chaing Rai fertility level lagging about 5 years behind that of Chiang Mai. In both changwats, expectations of and desire for large families have virtually disappeared although Chaing Rai women expected larger families than Chiang Mai women. Infant mortality rates were lower in Chiang Mai due to improved MCH services. While the reported rates of induced abortion were low for both provinces, indications are that the actual rates are about 3 times higher for Chiang Mai -- in line with the lower fertility performance and desires reported there. Attitudes toward family planning were favorable in both changwats but knowledge of contraceptive use was greater in Chiang Mai. Statistics of contraceptive use correlated to levels of knowledge and to activities of family planning programs. The article concludes that nearly all of the fertility declines observed are the result of organized family planning activities.

Fertility and Family Planning in Rural Northern Thailand

From the mid-1960s to the mid-1970s, when fertility was declining in Thailand as a whole, especially rapid declines occurred in Northern Thailand, but they did not occur uniformly in all the region's provinces. The Northern Thailand Fertility Study, initiated in 1975 to study the reported fertility changes, gathered data in two provinces: Chiang Mai, where fertility decline has been quite rapid, and Chiang Rai, which experienced relatively little decline until 1974. This preliminary report discusses fertility levels and trends in the two provinces, fertility experience and expectations of respondents, attitudes toward and knowledge of family planning, and contraceptive practice. The results suggest that most of the difference in fertility decline is related to the different level of family planning program activity in the two provinces.

Family planning program activity and patient enrollment rates in the United States, 1969 and 1971

The effects of demographic characteristics, socioeconomic conditions, health care, and family planning program activity on patient enrollment rates are estimated for 1969 and 1971. Two program activity variables (agencies and clinic locations) have significant, positive net effects in both years. The effect of agencies changed little between 1969 and 1971, and it is the strongest effect in both years. The effect of clinic locations more than doubled between 1969 and 1971, partly due to increased demand. The direct effects of the demographic, socioeconomic, and health care variables are not large, but many of the demographic and socioeconomic variables have substantial indirect effects via health care program activity.