Reliability Estimates Research Articles

Extending the predictive power of perturbative QCD using the principle of maximum conformality and the Bayesian analysis

In addition to the evaluation of high-order loop contributions, the precision and predictive power of perturbative QCD (pQCD) predictions depends on two important issues: (1) how to achieve a reliable, convergent fixed-order series, and (2) how to reliably estimate the contributions of unknown higher-order terms. The recursive use of renormalization group equation, together with the Principle of Maximum Conformality (PMC), eliminates the renormalization scheme-and-scale ambiguities of the conventional pQCD series. The result is a conformal, scale-invariant series of finite order which also satisfies all of the principles of the renormalization group. In this paper we propose a novel Bayesian-based approach to estimate the size of the unknown higher order contributions based on an optimized analysis of probability distributions. We show that by using the PMC conformal series, in combination with the Bayesian analysis, one can consistently achieve high degree of reliability estimates for the unknown high order terms. Thus the predictive power of pQCD can be greatly improved. We illustrate this procedure for two pQCD observables: R_{e^+e^-} and R_tau , which are each known up to four loops in pQCD. Numerical analyses confirm that by using the scale-independent and more convergent PMC conformal series, one can achieve reliable Bayesian probability estimates for the unknown higher-order contributions.

The Proposed Specifiers for Conduct Disorder - Parent (PSCD-P): Convergent Validity, Incremental Validity, and Reactions to Unfamiliar Peer Confederates.

Youth who experience psychopathy display multiple impairments across interpersonal (grandiose-manipulative [GM]), affective (callous-unemotional [CU]), lifestyle (daring-impulsive [DI]), and potentially antisocial and behavioral features. Recently, it has been acknowledged that the inclusion of psychopathic features can offer valuable information in relation to the etiology of Conduct Disorder (CD). Yet, prior work largely focuses on the affective component of psychopathy, namely CU. This focus creates uncertainty in the literature on the incremental value of a multicomponent approach to understanding CD-linked domains. Consequently, researchers developed the Proposed Specifiers for Conduct Disorder (PSCD; Salekin & Hare, 2016) as a multicomponent approach to assess GM, CU, and DI features in combination with CD symptoms. The notion of considering the wider set of psychopathic features for CD specification requires testing whether multiple personality dimensions predict domain-relevant criterion outcomes above-and-beyond a CU-based approach. Thus, we tested the psychometric properties of parents' reports on the PSCD (PSCD-P) in a mixed clinical/community sample of 134 adolescents (Mage = 14.49, 66.4% female). Confirmatory factor analyses resulted in a 19-item PSCD-P displaying acceptable reliability estimates and a bifactor solution consisting of GM, CU, DI, and CD factors. Findings supported the incremental validity of scores taken from the PSCD-P across multiple criterion variables, including (a) an established survey measure of parent-adolescent conflict; and (b) trained independent observers' ratings of adolescents' behavioral reactions to laboratory controlled tasks designed to simulate social interactions with unfamiliar peers. These findings have important implications for future research on the PSCD and links to adolescents' interpersonal functioning.

The Preventiometer - reliability of a cardiovascular multi-device measurement platform and its measurement agreement with a cohort study

BackgroundMultimedia multi-device measurement platforms may make the assessment of prevention-related medical variables with a focus on cardiovascular outcomes more attractive and time-efficient. The aim of the studies was to evaluate the reliability (Study 1) and the measurement agreement with a cohort study (Study 2) of selected measures of such a device, the Preventiometer.MethodsIn Study 1 (N = 75), we conducted repeated measurements in two Preventiometers for four examinations (blood pressure measurement, pulse oximetry, body fat measurement, and spirometry) to analyze their agreement and derive (retest-)reliability estimates. In Study 2 (N = 150), we compared somatometry, blood pressure, pulse oximetry, body fat, and spirometry measurements in the Preventiometer with corresponding measurements used in the population-based Study of Health in Pomerania (SHIP) to evaluate measurement agreement.ResultsIntraclass correlations coefficients (ICCs) ranged from .84 to .99 for all examinations in Study 1. Whereas bias was not an issue for most examinations in Study 2, limits of agreement for most examinations were very large compared to results of similar method comparison studies.ConclusionWe observed a high retest-reliability of the assessed clinical examinations in the Preventiometer. Some disagreements between Preventiometer and SHIP examinations can be attributed to procedural differences in the examinations. Methodological and technical improvements are recommended before using the Preventiometer in population-based research.

Deepening the understanding of the structural validity of the Tilburg Frailty Indicator

BackgroundPsychometric properties of the Tilburg Frailty Indicator (TFI) have shown low internal consistency for psychological and social domains, and evidence for its structure validity is controversial. Moreover, research on TFI is frequently limited to community dwellings.AimsTo evaluate structural validity, reliability, and convergent and divergent validity of the Spanish version of the Tilburg Frailty Indicator (TFI) in both community-dwelling and institutionalized older people.Materials and methodsA cross-sectional study was conducted on Spanish older adults (n = 457) recruited from both community settings (n = 322) and nursing homes (n = 135). Participants completed the TFI and other frailty instruments: Fried’s Frailty Phenotype, Edmonton Frailty Scale, FRAIL Scale, and Kihon Checklist (KCL). Confirmatory Factor Analysis (CFA), and reliability and validity coefficients were estimated.Results and discussionSome items from physical and social domains showed low factor loadings (< 0.40). The three-factor CFA model showed better fit indices after depurating these items. Reliability estimates were good (CRI ≥ 0.70) for physical and psychological domains in the institutionalized sample, while in the community dwellings, only physical domain reliability was adequate. Convergent and divergent validity of physical and psychological domains was good, except for some alternative psychological measures highly correlating with the TFI physical component (KCL-depressive mood and Edmonton mood). However, the social domain showed low correlations with some social indicators.ConclusionThe findings of this study clarify some of the controversial validation results of the TFI structure and provide evidence to improve its use in psychometric terms.Clinical trial registration numberNCT03832608.

Development and initial validation of the addressing client needs with social determinants of health scale (ACN: SDH)

BackgroundThe purpose of this study was to validate a scale that can be used by healthcare service professionals, healthcare systems, educators, and researchers to assess health service professionals’ social determinants of health (SDOH) competency; with competency defined as their knowledge, awareness-biases, skills, and actual preparedness to address SDOH challenges.MethodsAn Exploratory Factor Analysis (EFA) was conducted with a sample of 220 health service professionals, and 6 factors were identified. A Confirmatory Factor Analysis (CFA) was conducted with 303 health service professionals and the 6-factor solution was supported, with 22 items.ResultsThe reliability estimates for the 6 factors are as follows: Factor 1, Action Toward Addressing SDOH (a = .85); Factor 2, SDOH Knowledge (a = .94); Factor 3, Negative Attitude toward Addressing SDOH (a = .79); Factor 4, Systemic Accountability (a = .81); Factor 5, School Preparation (a = .86); and Factor 6, Perception of the Cause of SDOH (a = .94).ConclusionThe ACN:SDH scale is the first validated measure that can be used to systematically appraise health service professionals’ SDOH competency.

Modelling seasonal household variation in harvested rainwater availability: a case study in Siaya County, Kenya

Rainwater harvesting reliability, the proportion of days annually when rainwater demand is fully met, is challenging to estimate from cross-sectional household surveys that underpin international monitoring. This study investigated the use of a modelling approach that integrates household surveys with gridded precipitation data to evaluate rainwater harvesting reliability, using two local-scale household surveys in rural Siaya County, Kenya as an illustrative case study. We interviewed 234 households, administering a standard questionnaire that also identified the source of household stored drinking water. Logistic mixed effects models estimated stored rainwater availability from household and climatological variables, with random effects accounting for unobserved heterogeneity. Household rainwater availability was significantly associated with seasonality, storage capacity, and access to alternative improved water sources. Most households (95.1%) that consumed rainwater faced insufficient supply of rainwater available for potable needs throughout the year, with intermittencies during the short rains for most households with alternative improved sources. Although not significant, stored rainwater lasts longer for households whose only improved water source was rainwater (301.8 ± 40.2 days) compared to those having multiple improved sources (144.4 ± 63.7 days). Such modelling analysis could enable rainwater harvesting reliability estimation, and thereby national/international monitoring and targeted follow-up fieldwork to support rainwater harvesting.

Development of informant-report neurobehavioral survey scales for PTEN hamartoma tumor syndrome and related neurodevelopmental genetic syndromes.

There are few well-validated measures that are appropriate for assessing the full range of neurobehavioral presentations in PTEN hamartoma tumor syndrome (PHTS) and other neurodevelopmental genetic syndromes (NDGS). As potential therapeutics are developed, having reliable, valid, free, and easily accessible measures to track a range of neurobehavioral domains will be crucial for future clinical trials. This study focused on the development and initial psychometric evaluation of a set of freely available informant-report survey scales for PHTS-the Neurobehavioral Evaluation Tool (NET). Concept elicitation, quantitative ratings, and cognitive interviewing processes were conducted with stakeholders and clinician-scientist experts, used to identify the most important neurobehavioral domains for this population, and to ensure items were appropriate for the full range of individuals with PHTS. Results of this process identified a PHTS neurobehavioral impact model with 11 domains. The final NET scales assessing these domains were administered to a sample of 384 participants (median completion time = 20.6 min), including 32 people with PHTS, 141 with other NDGS, 47 with idiopathic neurodevelopmental disorder (NDD), and 164 neurotypical controls. Initial psychometric results for the total scores of each scale indicated very good model (ω = 0.83-0.99) and internal consistency reliability (α = 0.82-0.98) as well as excellent test-retest reproducibility at 1-month follow-up (r = 0.78-0.98) and stability at 4-month follow-up (r = 0.76-0.96). Conditional reliability estimates indicated very strong measurement precision in key score ranges for assessing PHTS and other people with NDGS and/or idiopathic NDD. Comparisons across domains between PHTS and the other groups revealed specific patterns of symptoms and functioning, including lower levels of challenging behavior and more developed daily living and executive functioning skills relative to other NDGS. The NET appears to be a reliable and potentially useful tool for clinical characterization and monitoring of neurobehavioral symptoms in PHTS and may also have utility in the assessment of other NDGS and idiopathic NDD. Additional validation work, including convergent and discriminant validity analyses, are needed to replicate and extend these observations.

Інтервальна оцінка показників надійності за результатами випробувань компонентів складної системи

The goal of this work is to find the lower estimate of the no-failure probability (NFP) of a complex monotonic nonrecoverable system from the results of independent binomial tests of its components. Using the general-and-probabilistic method, the NFP is considered as a probability function polynomial, which is a linear homogeneous polynomial in each of the S variables where S is the number of system component types. Based on the method of confidence sets, the NFP lower estimate is found as the minimum of a function of an unknown multidimensional parameter at a probability of the aggregate test results (failure-free operation) of the system components equal to one minus the guaranteed confidence coefficient. The paper reports a system of equations, each of which for two component types relates the component reliability derivatives of the NFP (and one more equation relates the component reliability and the confidence coefficient). Conditions are found for the initial guess in a numerical solution of the above system of nonlinear equations (the number of the conditions is equal to the number of the component types minus one; each condition is a like sign for two functions each of which depends on the probability of the test results of a particular component type and the component reliability of this probability). In some specific cases, the program dimension can be reduced due to the simple structure of the probability function polynomial. The presented method gives a confidence reliability estimate with a guaranteed confidence coefficient for complex system that cannot be reduced to a serial-parallel or a parallel-serial structure and consist of components with an arbitrary type of failure time distribution. The method allows one to get an estimate at a small number of tests and a small number of failures or in their absence, which is of especial importance for high-reliability systems.

Measuring Intellectual Curiosity across Cultures: Validity and Comparability of a New Scale in Six Languages

Intellectual curiosity—the tendency to seek out and engage in opportunities for effortful cognitive activity—is a crucial construct in educational research and beyond. Measures of intellectual curiosity vary widely in psychometric quality, and few measures have demonstrated validity and comparability of scores across multiple languages. We analyzed a novel, six-item intellectual curiosity scale (ICS) originally developed for cross-national comparisons in the context of the OECD’s Programme for the International Assessment of Adult Competencies (PIAAC). Samples from six countries representing six national languages (U.S. Germany, France, Spain, Poland, and Japan; total N = 5,557) confirmed that the ICS possesses very good psychometric properties. The scale is essentially unidimensional and showed excellent reliability estimates. On top of factorial validity, the scale demonstrated strict measurement invariance across demographic segments (gender, age groups, and educational strata) and at least partial scalar invariance across countries. As per its convergent and divergent associations with a broad range of constructs (e.g., Open-Mindedness and other Big Five traits, Perseverance, Sensation Seeking, Job Orientations, and Vocational Interests), it also showed convincing construct validity. Given its internal and external relationships, we recommend the ICS for assessing intellectual curiosity, especially in cross-cultural research applications, yet we also point out future research areas.

Reliability of the Commonly Used and Newly-Developed Autism Measures.

The aim of the present study was to compare scale and conditional reliability derived from item response theory analyses among the most commonly used, as well as several newly developed, observation, interview, and parent-report autism instruments. When available, data sets were combined to facilitate large sample evaluation. Scale reliability (internal consistency, average corrected item-total correlations, and model reliability) and conditional reliability estimates were computed for total scores and for measure subscales. Generally good to excellent scale reliability was observed for total scores for all measures, scale reliability was weaker for RRB subscales of the ADOS and ADI-R, reflecting the relatively small number of items for these measures. For diagnostic measures, conditional reliability tended to be very good (> 0.80) in the regions of the latent trait where ASD and non-ASD developmental disability cases would be differentiated. For parent-report scales, conditional reliability of total scores tended to be excellent (> 0.90) across very wide ranges of autism symptom levels, with a few notable exceptions. These findings support the use of all of the clinical observation, interview, and parent-report autism symptom measures examined, but also suggest specific limitations that warrant consideration when choosing measures for specific clinical or research applications.

Reliability Estimation of Burr Type III Distribution under Improved Adaptive Progressive Censoring with Application to Surface Coating

The stress-strength reliability (SSRe) model is widely investigated in reliability engineering to determine the probability of the strength component overcomes the stress imposed on it. In this paper, we studied the estimation of SSRe model based on the Burr III distribution under the improved adaptive progressive type-II censoring scheme (IAPrgCS-II). Estimation methods of the SSRe parameters are developed using frequentist and Bayesian approaches. The point and interval estimations using the maximum likelihood are considered to estimate the parameters. Two approximations are applied to compute the Bayes estimates. A simulation study is conducted for the comparison of the methods of estimation. Also, parallel to the development of reliability studies, it is necessary to study its application in different sciences such as engineering. Therefore, the droplet splashing (DrS) data under two wettabilities are proposed as an application of the considered SSRe model and methods. The results show us that the reliability model can be used to amend the quality of coatings.

Effect of antecedent drought stress on spring green‐up in turf‐type bermudagrasses

AbstractWinterkill is a major concern for turf‐type bermudagrasses [Cynodon dactylon (L.) Pers. and C. dactylon (L.) Pers. × C. transvaalensis Burtt‐Davy] when cultivated in the US transition zone and frequently occurring drought conditions challenge bermudagrass management. Therefore, developing new bermudagrasses with both drought resistance and winter survivability are needed for the future sustainability of the turfgrass industry in the transition zone. How these two traits interact within bermudagrass populations is not widely reported. Accordingly, the objectives of this study were to estimate reliability for spring green‐up (SG) (as an indicator of winter survivability) and drought response in turf‐type bermudagrasses. A total of 77 experimental genotypes and 7 cultivars were planted in a randomized complete block design with 3 replications over 2 years in Goodwell, OK, USA. Substantial genetic variations were found for drought response and SG parameters when analyzed by year, but variations for SG parameters and leaf firing were not significant when analyzed across years. The reliability estimates for drought response ranged from low to moderate (i2 = 0.24–0.61), whereas the subsequent estimates for SG were low (i2 = 0.13–0.33), suggesting poor reliability. The low‐to‐moderate reliability values in SG were likely due to antecedent drought injuries, indicating that winter survivability and drought resistance may need to be evaluated in separate trials.

Reliability Estimation under Normal Operating Conditions for Progressively Type-II XLindley Censored Data

This paper assumes constant-stress accelerated life tests when the lifespan of the test units follows the XLindley distribution. In addition to the maximum likelihood estimation, the Bayesian estimation of the model parameters is acquired based on progressively Type-II censored samples. The point and interval estimations of the model parameters and some reliability indices under normal operating conditions at mission time are derived using both estimation methods. Using the Markov chain Monte Carlo algorithm, the Bayes estimates are calculated using the squared error loss function. Simulating the performances of the different estimation methods is performed to illustrate the proposed methodology. As an example of how the proposed methods can be applied, we look at two real-life accelerated life test cases. According to the numerical outcomes and based on some criteria, including the root of the mean square error and interval length, we can conclude that the Bayesian estimation method based on the Markov chain Monte Carlo procedure performs better than the classical methods in evaluating the XLindley parameters and some of its reliability measures when a constant-stress accelerated life test is applied with progressively Type-II censoring.

Internal consistency and structural validity of the nomophobia questionnaire (NMP-Q) and its translations: A systematic review with meta-analysis

BackgroundA psychological condition known as NOMOPHOBIA causes individuals to fear losing ability to use or reach their mobile phones. The NMP-Q (nomophobia questionnaire) is a commonly used survey for assessing symptoms related to nomophobia. Materials and methodsWe performed a meta-analysis using reliability generalization (RG) on the NMP-Q. Thirteen studies involving 15,929 participants have reported original reliability estimates of the NMP-Q determined through a comprehensive and methodical examination of the available literature. ResultsFor the total scores, the pooled internal consistency reliability was 0.93 [0.91; 0.95] and for the subscales it ranged from 0.83 to 0.91. Specifically, 0.91 [0.88; 0.93], 0.84 [0.80; 0.88], 0.83 [0.78; 0.88, and 0.83 [0.80; 0.85] for the subscales. Subscale 1 = not being able to communicate; subscale 2 = losing connectedness; subscale 3 = not being able to access information; and subscale 4 = giving up convenience”, respectively. All reported effect sizes are Cronbach's alphas. Structural validity supported a solution of four-factors. ConclusionsNMP-Q has an excellent internal consistency. Structural validity of four factors appears to be vigorous in fitting NMP-Q items. Our recommendation is to require future studies using NMP-Q to provide a reliability estimate based on their own data.

A Framework for Reliability Analysis of Combinational Circuits Using Approximate Bayesian Inference

A commonly used approach to compute the error rate at the primary outputs (POs) of a circuit is to compare the fault-free and faulty copies of the circuit using XOR gates. This model results in poor accuracies with nonsampling-based methods for reliability estimation. An alternative is to use a single copy of the circuit with a four-valued representation for each net corresponding to the correct and incorrect signals. One problem in this formulation is the accurate propagation of associated probabilities. We use the framework of Bayesian inference (BI) to address this issue. We derive the conditional probability distribution (CPD) corresponding to the four-valued signals and find the output error rate using various approximate BI techniques. With our formulation, we demonstrate that the output error rate scales with the gate error probabilities. It is guaranteed to be zero when the gate error probability is zero, provided approximate BI algorithms based on sum-product belief propagation (BP) are used. Although inaccuracies increase at very low gate error probabilities, it is able to capture the relative reliability of outputs with respect to each other. We also propose a new method for finding the overall circuit error rate as the partition function for a fixed state of POs. This method provides a significant improvement in accuracy when compared with the existing method using OR gates.

Heuristic algorithms for reliability estimation based on breadth-first search of a grid tree

Heuristic algorithms for reliability estimation based on breadth-first search of a grid tree

Psychometric properties of the Arabic version of the Intuitive Eating Scale-2 (IES-2) in a sample of community adults

BackgroundThere is a growing attention on intuitive eating (IE) styles in the Western world that has not yet reached Arab countries, which is likely due to the lack of psychometrically sound measures of the IE construct for Arabic-speaking people. The current study aims to examine the psychometric properties of an Arabic translation of the most widely used measure of IE—the Intuitive Eating Scale-2 (IES-2), in an Arabic-speaking community population from Lebanon.MethodsTwo samples of Arabic-speaking community adults from Lebanon (sample 1: n = 359, 59.9% females, age 22.75 ± 7.04 years; sample 2: n = 444, 72.7% females, age 27.25 ± 9.53 years) were recruited through online convenience sampling. The translation and back-translation method was applied to the IES-2 for linguistic validation. Factorial validity was investigated using an Exploratory Factor Analysis & Confirmatory Factor Analysis strategy. Composite reliability and sex invariance were examined. We also tested convergent and criterion-related validity through correlations with other theoretically plausible constructs.ResultsNine out of the original 23 items were removed because they either loaded below 0.40 and/or cross-loaded too highly on multiple factors. This resulted in four domains (Unconditional Permission to Eat, Eating for Physical Rather than Emotional Reasons, Reliance on Hunger and Satiety Cues, and Body-Food Choice Congruence) and 14 items retained. Internal reliability estimates were excellent, with McDonald’s ω values ranging from 0.828 to 0.923 for the four factors. Multigroup analysis established configural, thresholds, metric, scalar, strict invariance across gender. Finally, higher IES-2 total scores were significantly correlated with lower body dissatisfaction scores and more positive eating attitudes, thus attesting to convergent and criterion-related validity of the scale.ConclusionsThe current findings provide preliminary evidence for the appropriate psychometric qualities of the Arabic 14-item, four-factor structure IES-2; thereby supporting its use at least among Arabic-speaking community adults.

Estimation of $Pr(X&lt;Y)$ for exponential power records

In this study, we tackle the problem of estimation of stress-strength reliability $R = P r(X &amp;lt; Y )$ based on upper record values for exponential power distribution. We use the maximum likelihood and Bayes methods to estimate R. The Tierney-Kadane approximation is used to compute the Bayes estimation of R since the Bayes estimator can not be obtained analytically. We also derive asymptotic confidence interval based on the asymptotic distribution of the maximum likelihood estimator of R. We consider a Monte Carlo simulation study in order to compare the performances of the maximum likelihood estimators and Bayes estimators according to mean square error criteria. Finally, a real data application is presented.

Validity, reliability and prevalence estimates of nomophobia among undergraduate dental students of Bhubaneswar, India.

Considered a modern phobia, Nomophobia (NO MObile PHOne PhoBIA) is a term describing irrational fear or anxiety of being unable to access one's own mobile phone. To develop and validate the nomophobia questionnaire, administering it to a sample of adolescents representing undergraduate dental students. To assess the prevalence of Nomophobia, determine the usage pattern of mobile phones and evaluate the impact due to lack of access to mobile phones among undergraduate dental students. A cross-sectional study was conducted on 302 undergraduate students of Bhubaneswar through a self-administered questionnaire via Google Forms consisting of 19 items evaluating the pattern and anxiety related to usage of mobile phones. Responses were recorded on a 5-point Likert scale. Kruskal Wallis, Mann-Whitney U and Chisquare tests were used for statistical analysis. Test-Retest reliability showed kappa of k=0.86 and Internal consistency Chronbach's-Alpha to be α=0.82. Prevalence of nomophobia (score ≥ 58) was 32.1%, and students at risk of being nomophobic (score 39-57) was 61.9%. It was highest in males (32.6%) and amongst the interns (41.9%) and lowest (25.5%) amongst the second-year students. Participants felt nervous/insecure if their phones were away from them because of the fear that somebody might have accessed their data (3.07±1.93) and or tried to contact them (3.09±1.13) which were not statistically significant (p>0.05). The present study confirms that nomophobia is an emerging behavioural addiction among dental students. Adequate prevention strategies would be helpful in reducing the impact of the chronic mobile usage. Effect of the mobile phone on dental students and the fear of not having it with them is increasing elaborately, that needs to be controlled. Otherwise, it would negatively affect their academic achievement and well-being.

Socio-Cultural Practices and Fertility Behaviour of Rural Dwellers in Alayi, Abia State, Nigeria

This study was carried to investigate the influence of socio-cultural practice (male child preference; women marginalization and adoption of large family size) on fertility behaviour in Alayi community. Survey design was adopted for this study. Data collection was carried out using two methods (questionnaire and Focus Group Discussions-FGDs). The questionnaire consists of four sections, with twenty items arranged on four Point Likert-type formats. A pilot test of the instruments gave reliability estimates of 0.5. Using the proportional stratified and purposive sampling technique, 356 respondents were sampled from a population of 3,273 respondents across the study area. Three hypotheses were formulated and tested using chi-square at 0.05 level of significance. Results obtained indicated that there is a significant influence of male child preference, women marginalization and adoption of large family size on the fertility behaviour of Alayi people. Also, result from the socio demographic data of respondents indicates that the level of education and occupation of respondents has a far-reaching implication for large family size among the Alayi people. It is recommended among others that age of entry into marriage should be checkmated by parents and stakeholders to prevent women from falling victims of circumstances. Also, there should be an appeal for the shift in the traditional beliefs and attitudes in which people consider many children with preferences to sons and synonymous with wealth. Lastly, the existing family planning programme should be strengthened and expanded to ensure that couples and individuals have uninterrupted access to the range of contraceptive methods at affordable prices.