Attitudes toward family planning, marriage, and family size among unmarried women in Korea.

Data from the 1973 National Fertility and Family Planning Survey show that young unmarried women aged 18-27 desire small families and support family planning. These women express a lower son preference than did young currently married women surveved in 1973 and earlier. A majority of the respondents approve of the "stop at two" slogen of the family planning association, and they want to obtain more information about contraception before marrying. Unfortunately, survey results show that present sources of contraceptive information, including the schools, have not proved adequate.     

Differentials in fertility, family planning practice, and family size values in South Korea, 1965-1971.

Data from five Korean national KAP surveys of currently married women, conducted between 1965 and 1971, are analyzed to determine whether differentials have emerged or are emerging between urban and rural women in three factors of crucial importance for population growth: fertility, family planning practice, and family size values. Graphics are used throughout to analyze urban-rural differentials and trends in these factors over time. In addition, two statistical tests, the sign and binomial, are applied to the differentials to provide a tabular summary of results. Part I provides background information on population growth, urbanization, the achievements of the national family planning program, and economic development in Korea since the 1950's. Part II describes both urban-rural differentials in fertility, as measured by mean parity, for married women aged 30-39 between 1966 and 1971; and urban-rural differentials in the proportions of women aged 25-39 currently practicing family planning between 1965 and 1971. Part III analyzes urban-rural differences in ideal family size and ideal number of sons, controlling for number of living children and number of living sons. Part IV attempts to evaluate the impact of the national family planning program on the fertility, family planning practice, and family size values of the rural population by examining the findings on urban-rural differentials in the context of social and economic development, viewing the program as one of a multitude of variables that can affect these factors.     

Misinformation and fear of side-effects of family planning

Fears about the side-effects from family planning are well-documented barriers to use. Many fears are misinformation, while others reflect real experience, and understanding of these is not complete. Using qualitative interviews with women in three countries, this study examines what women feared, how they acquired this knowledge, and how it impacted on decision-making. We aimed to understand whether women would be more likely to use family planning if they were counselled that the side-effects they feared were inaccurate. Across all countries, respondents had a similar host of fears and misinformation about family planning, which were comprised of a mixture of personal experience and rumour. Most fears were method-specific and respondents overwhelmingly stated that they would be more likely to use the family planning method they feared if counselled that there were no side-effects. This suggests programmes should focus on education about family planning methods and method mix.     

Misinformation and fear of side-effects of family planning

Fears about the side-effects from family planning are well-documented barriers to use. Many fears are misinformation, while others reflect real experience, and understanding of these is not complete. Using qualitative interviews with women in three countries, this study examines what women feared, how they acquired this knowledge, and how it impacted on decision-making. We aimed to understand whether women would be more likely to use family planning if they were counselled that the side-effects they feared were inaccurate. Across all countries, respondents had a similar host of fears and misinformation about family planning, which were comprised of a mixture of personal experience and rumour. Most fears were method-specific and respondents overwhelmingly stated that they would be more likely to use the family planning method they feared if counselled that there were no side-effects. This suggests programmes should focus on education about family planning methods and method mix.     

How family planning ideas are spread within social groups in rural Malawi

Using data from in-depth interviews conducted between March and June 2002 in a rural district of Malawi, this study explores how family planning attitudes and practices spread among members of social groups. Gender differentials are found in how people determine other group members' practices: Men "knew" about such practices from their observations of others' family size and child spacing, whereas women's knowledge was based on their conversations with other women. The discussion topics relating to family planning also varied by sex: Men spoke about the pros and cons of limiting family size, whereas women spoke in detail about types of contraceptive methods, where to get them, their side effects, and covert contraceptive use. For men and women, the main trigger for family planning discussions was gossip. Whereas, generally, women first heard about family planning at the hospital, men stated that their first source of information was the radio or health-drama group.     

Family planning and adoption promotion: new proposals,long-standing issues

This paper sheds lights on long-standing issues and new proposals on family planning and adoption promotion. The spate of bills promoting adoption in Title X family planning clinics and federally funded health centers by opponents of family planning programs raise a significant concern in the family planning community. This concern gave rise to questions on the nature of adoption counseling that should be offered to pregnant women in government-funded programs and the extent to which family planning programs should assume the duties of adoption agencies. Budgetary constraints also raise a serious question on the degree to which family planning funds should be rechanneled to serve this purpose. One more immediate issue, however, is the fact that two of the proposed strategies deny women facing pregnancy crisis the right to informed decision on their options by preventing family planning providers to discuss on abortion. Other measures set include the revival of the abortion "gag rule" previously imposed by the Reagan and Bush administrations and promoting a program of direct federal subsidy to organizations which provide counseling to women provided that these organizations shall provide full information on pregnancy options.     

The effects of health facility access and quality on family planning decisions in urban Senegal

Research in developing countries is rarely focused on examining how supply side factors affect family planning decisions due to a lack of facility‐level data. When these data exist, analyses tend to focus on rural environments. In this paper, we study the effects that health facility access and quality have on contraceptive use and desired number of children for women in urban Senegal. Unlike related studies focusing on rural environments, we find no evidence that greater access to health facilities and pharmacies increases contraceptive use among urban women. However, we do find that contraceptive use among urban women is higher with greater facility quality. For example, we find that increasing the proportion of pharmacies employing multiple pharmacists from 0% to 50% would increase contraceptive use by 6.0 percentage points, and increasing the proportion of facilities with family planning guidelines/protocols from 50% to 100% would increase use by 2.1 percentage points.     

Knowledge, attitudes, and practice of family planning in the Philippines, 1972

Some major findings from the 1972 survey of family planning knowledge, attitudes, and practice (KAP) are presented, particularly those related to relationships between family planning and various demographic and social variables, in order to describe the current status of family planning knowledge, attitudes, and practice in the Philippines. Attention is directed to some rather substantial changes that have occurred since 1968, as revealed by comparison of 1972 data with selected findings of the 1968 National Demographic Survey. The sample was chosen according to a multi-stage probability sampling design. All sample households with ever-married women aged 15-49 were included in the survey. A total of 9232 every-married women from 11,837 households were interviewed. The percentage of women who indicated that they did not want an additional child increased as the number of living children increased. The largest percentage of women in the sample had 3 or 4 living children; 69% of these women stated that they did not want an additional child. The median number of children desired showed a corresponding decline from 5.1 in 1968 to 3.9 in 1972. Among both urban and rural women, there was an increase between 1968 and 1972 in the percentage of women who stated an ideal or desired family size of 4 or fewer children. The increase was greater in all categories among rural women than among urban women, indicating that family size norms are changing more rapidly in the rural areas. In contrast to 1968, when only 4% of all respondents were able to recognize at least 1 contraceptive method when it was mentioned to them, in 1972, 86% could identify at least 1 method without assistance. Of all contraceptive methods, knowledge of the IUD showed the largest increase since 1968. Both surveys established positive correlation between education and income and approvalof family planning, while age and number of living children did not appear to exert much influence on a woman's attitude. Contraceptive practice (ever-use) increased from 19-32%. Almost all women who indicated that they had used a method recently were still current users at the time of the survey. Rhythm, oral contraception, and withdrawal were the most commonly used methods. The largest percentage of contraceptive materials were supplied by druggists and local physicians; family planning centers supplied about 1/4 of all respondents with pills and IUDs.     

Smart patient, smart community: improving client participation in family planning consultations through a community education and mass-media program in Indonesia

In health care consultations, patients often receive insufficient information from providers and communicate little with providers about their needs or concerns. This study evaluated a combined community education and mass media intervention to improve clients' participation in family planning consultations. A household survey was conducted with 1,200 women in three sub-districts (two intervention and one control) of West Java province in Indonesia. A comparison of post-campaign findings among family planning clients suggests that the intervention as a whole had a positive effect on client participation, specifically the number of clients who prepared questions to ask the service provider prior to a family planning visit in the past year. Multivariate analyses showed that the "Smart Card" intervention and elements of the "Sahabat" (Friend) mass media campaign were positively associated with clients' preparation of questions and question asking behavior during family planning consultations, indicating that a combined community education and mass-media approach can improve client communication with providers and improve the quality of family planning counseling.     

Hindrances to family planning program: findings from Banke, Nepal

Reducing population growth through programs is a high priority for many developing countries. Why particularly in the rural regions of these countries, do these initiatives fail? Using a case study of a recent initiative in rural Nepal between 1998 and 2002 as an example, this opinion piece discusses possible reasons for such failure and recommends that a broader strategic approach is necessary, particularly in relation to empowering women in these communities. Banke district, Nepal, is mainly rural, consisting of 47 villages. Scarcity of family planning provisions is a dominant problem in most parts of the district. District Public Health Office (DPHO), the major family service provider lacks resources and technical capabilities. In recent years, non-government organizations (NGOs) have been collaborating and coordinating their efforts with DPHO in order to cover the larger section of the district population. A local NGO called Banke Mahila Arthick Swawlamban Sangathan (BMASS) provided family planning services in 5 of the 47 villages of Banke district, Nepal, from 1998 through 2002. Outreach activities and clinical services were the two major components of BMASS family planning program. Outreach activities included door-to-door/mass counseling, street drama, and condom distribution. Clinical services that included counseling, testing, temporary sterilization, and referrals for permanent sterilization were provided through a centrally located static clinic and mobile clinics. BMASS family planning program had almost no impact in the target villages. There was no significant increase in contraceptive use, people's motivation to limit fertility, and number of people preferring a smaller family size. The contraceptive prevalence rate increased by less than 2% after 2 years of family planning program intervention. More than 80% of the family planning clients were reported to have discontinued contraceptive use within six months. The mean age of women at the time of first child delivery (16.2 years), total fertility rate (six children per woman), and the birth intervals (13-18 months) were reported to be the same for both periods: before and two years after family planning program intervention. Further assessment of the local factors revealed that women's lack of control over fertility and higher number of desired children could have hindered the community's response to BMASS family planning program. In the target villages a woman's fertility is dependent upon the preference of husbands and in-laws. The women in general are not empowered to voice their opinion with regards to delaying fertility, spacing child-births, and limiting the number of children to be born to them. Higher number of desired children in the target villages is the outcome of low cost of child rearing and high benefits from the children. Children not only contribute significantly in household economy and provide old age security to their parents, but also consume less. To be effective, family planning programs need to be integrated into broader societal reforms that address rural economic development and the role of women in society.     

Gender inequality, family planning, and maternal and child care in a rural Chinese county

This study examines the determinants of prenatal and obstetric care utilization within the context of recent social and economic changes in contemporary rural China. The aim of this study is to test the general hypothesis that gender inequality (women's status and son preference) and the state's family planning policy have a significant influence on maternal and childcare utilization. Both qualitative and quantitative data from a field survey in 1994 in rural Yunnan were used in the study. The findings lend support to this hypothesis. For example, the extent to which the husband shares housework and childcare, as an important marker of rural Chinese women's position within the family, is positively associated with the likelihood that a woman receives prenatal examinations, stops heavy physical work before birth, and gives birth under aseptic conditions. Also, a woman's exposure to the larger world beyond the village increases her chances of giving birth with the assistance of a doctor or health worker. Son preference is an impeding factor for maternal and child health care utilization. Already having a son in the family reduces the chances that the mother will stop heavy physical work before birth for a subsequent pregnancy. Female infants with older sisters are the least likely to receive immunizations. Women with "outside the plan" pregnancies are less likely than those with "approved" pregnancies to receive prenatal examinations, to stop strenuous work before birth, and to deliver under aseptic conditions. Thus, the study provides further evidence that the family planning policy has a negative impact on women and their families, whose fertility and son preferences conflict with the birth control policy.     

Bound and gagged: America's family planning network

During the past decade, the number of family planning clinics receiving support from the federal government has fallen from 5,000 to 4,000 despite a growing demand for their services among poor women and teenagers. At the same time, family planning providers have been under regulatory attack, forced to fend off a "squeal rule" aimed at teenagers and to stop a "gag rule" preventing abortion referral. With the climate in Washington unlikely to change, family planners should consider integrating other services into their network or press to include family planning in other care networks. A new national commission could help break the logjam on federal legislation.     

The behavior of Italian family physicians regarding the health problems of women and, in particular, family planning (both contraception and NFP)

The hospital-centered trend that has dominated medical culture and the management of health care during this entire century has, in the last few years, undergone a reversal in Italy. Conditions in other countries suggest that similar changes have or will become increasingly common. The family physician today manages many of the functions previously handled by hospitals and specialists. In the ¢eld of reproductive health, family physicians are responsible not only for diagnosis and treatment, but also for prevention and education. The present study considers this new context with the objective of investigating the knowledge and behavior of Italian family physicians in the ¢eld of women's health, with particular regard to family planning (including natural family planning), through (1) a qualitative study (focus groups) of a small group of family physicians and (2) a questionnaire sent to 500 family physicians throughout Italy. The results of the focus group are summarized in the form of obstacles that the family physician ¢nds in providing family planning services and proposals for change. The results indicate that because of their holistic approach, the family physician is an appropriate provider of family planning services although continued use of specialists' services, changes in logistics of the family physicians' practice, increased gender sensitivity, and additional training and information are necessary. The results of the questionnaire (121 responses, 24.2%) indicate that the Italian family physician currently lacks certain important information about family planning and would require logistical support to provide these services but is interested in acquiring information and is an appropriate family planning provider. An additional challenge for encouraging family practi- tioners to provide natural methods is that they favor a medical approach rather than a behavioral one in their treatment preferences for several other conditions.     

Effects of rural-urban return migration on women's family planning and reproductive health attitudes and behavior in rural China

This study examines the effects of rural–urban return migration on women's family planning and reproductive health attitudes and behavior in the sending areas of rural China. Based on data from a survey of rural women aged 16–40 in Sichuan and Anhui Provinces in 2000, our study finds that migrant women returning from cities to the countryside, especially those who have been living in a large city, are more likely than nonmigrant women to adopt positive family planning and reproductive health attitudes and behavior in their rural communities of origin. We find, moreover, that living in a rural community where the prevalence of such return migrant women is higher is positively associated with new fertility and gender attitudes and with knowledge of self-controllable contraceptives. The findings of significant rural-urban return-migration effects have important policy implications for shaping family planning and reproductive health attitudes and behaviors in rural China.     

Level of male involvement and associated factors in family planning services utilization among married men in Debremarkos town,Northwest Ethiopia

Background

Men’s participation is crucial to the success of family planning programs and women’s empowerment and associated with better outcomes in reproductive health such as contraceptive acceptance and continuation, and safer sexual behaviors. Limited choice and access to methods, attitudes of men towards family planning, perceived fear of side-effects, poor quality of available services, cultural or religious oppositions and gender-based barriers are some of the reasons for low utilization of family planning. Hence, this study assessed the level of male involvement in family planning services utilization and its associated factors in Debremarkos town, Northwest Ethiopia.

Methods

A community-based cross-sectional study was conducted from October to November, 2013. Multi-stage sampling technique was used to select 524 eligible samples. Data were collected by using semi-structured questionnaires. Epi Info and SPSS were used to enter and analyze the data; univariate, bivariate and logistic regression analyses were performed to display the outputs.

Results

Only 44 (8.4%) respondents were using or directly participating in the use of family planning services mainly male condoms. The reasons mentioned for the low participation were the desire to have more children, wife or partner refusal, fear of side effects, religious prohibition, lack of awareness about contraceptives and the thinking that it is the only issue for women. Opinion about family planning services, men approval and current use of family planning methods were associated with male involvement in the services utilization.

Conclusions

In this study, the level of male involvement was low. Lack of information, inaccessibility to the services and the desire to have more children were found to be the reasons for low male involvement in family planning services utilization. Governmental and nongovernmental organizations, donors and relevant stakeholders should ensure availability, accessibility and sustained advocacy for use of family planning services. The family planning programs should incorporate the responsibility and role of males in the uptake of family planning services.

     

Changes in ante-natal care and family planning in Krakor,Pursat, Cambodia, 1996-1998

This study examines variations in ante-natal care (ANC) and family planning in Krakor, Pursat, Cambodia between 1996 and 1998. Population-based survey interviews were conducted with a total of 291 women in 1996 and 211 women in 1998. An intervention strategy designed to enhance the skills and roles of Health Centre staff, Village Health Volunteers (VHVs) and Traditional Birth Attendants (TBAs) was conducted. Over this timeframe, reported ANC access increased from 37% to 47%. Most women delivered their last child at home, usually assisted by a TBA. Few women practiced family planning, despite the fact that most reported that they did not want any further children. A range of reasons for not practicing family planning were found to be highly significant, including the lack of available services (p<0.01). The fear of side-effects decreased significantly (p<0.01), with the community education provided by the VHVs and TBAs, potentially being one contributing factor. The results of this study suggest that continual support of VHVs and TBAs will further improve the health of women in Cambodia.     

A benefit-cost analysis of family planning services in Iowa.

An analysis of publicly funded family planning services in Iowa was undertaken to provide tangible estimates based on local data of the value of these services in averting unplanned and unwanted births to women who voluntarily use them. The study reports methods that can be applied by other states in evaluating their own family planning programs. Benefits were measured as the cost savings in public expenditures avoided by providing family planning services to low- and marginal-income women. Iowa data for AFDC, food stamps, and Medicaid payments were used to calculate benefits. The total benefit savings were adjusted to reflect the impact of family planning services on preventing births. The adjusted savings were accrued over one-year and five-year time frames and for four age groups (14-19, 20-29, 30-34, and 35-44). In the base year, the cost of providing family planning services in Iowa to the more than 56,000 women who used them was $3.1 million, or $59 per user. Results showed that the benefits of family planning services were highest for teenagers who would become eligible for public assistance programs upon the birth of a child.     

Fertility and family planning in Jordan: results from the 1985 Jordan Husbands' Fertility Survey

The 1985 Jordan Husbands' Fertility Survey (JHFS) was designed to assess husbands' attitudes and behavior toward fertility and family planning. The 1985 JHFS was a follow-up survey to obtain data from husbands of women who were currently married in the 1983 Jordan Fertility and Family Health Survey (JFFHS). The results from the 1985 JHFS point to the usefulness of collecting fertility and family planning information from husbands. These findings showed that nearly 40 percent of the husbands do not believe in practicing contraception, and more than 50 percent of the husbands report that family size should be "up to God." How program officials address these issues will be important for the future success of the family planning program in Jordan.     

Women's experiences with family planning

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