Studies In Family Planning[JOURNAL]
Sun
200 papers
The Educational Differentiation of African Birth Timing.
Frye M, Lopus S
Stud Fam Plann · 2025 Mar · PMID 39901326 · Full text
As educational access has expanded across Africa, birth timing has remained quite stable. Using data representing 51 birth years and 34 countries, we show that these modest aggregate changes mask more dramatic changes wi...
As educational access has expanded across Africa, birth timing has remained quite stable. Using data representing 51 birth years and 34 countries, we show that these modest aggregate changes mask more dramatic changes within educational groups. Over time, educational attainment has become an increasingly salient predictor of birth timing, as highly educated women have delayed first births and lengthened subsequent birth intervals more. The educational differentiation of birth timing also varies across contextual factors (educational access and family planning effort). In recent cohorts, women of all educational levels have experienced earlier first births in higher education contexts, suggesting that entry into motherhood is influenced by relative position within one's peer group. Aggregating across educational levels, however, women experience later first births in higher education contexts, driven by the greater share of highly educated women. For women at all levels of educational attainment, first birth timing is responsive to family planning context; in aggregate, women in countries with high family planning investments become mothers one year later than those in countries with lower family planning efforts. Notably, highly educated women lengthen their second birth intervals more when education and family planning are widely available, suggesting further potential for public investments to enable women to achieve their reproductive preferences.
Exploring Adolescents' Contraceptive Preferences and Trade-Offs: Findings From a Discrete Choice Experiment in Kenya.
Harrington EK, Ouma DC, Pike M … +7 more , Awuor M, Kimanthi S, Onono M, Barnabas RV, Mugo N, Bukusi EA, Hauber B
Stud Fam Plann · 2025 Mar · PMID 39780241 · Full text
A focus on contraceptive preferences is essential to the provision of person-centered care. Adolescent girls and young women (AGYW) in the WHO African Region experience disparities in contraceptive access and use and rep...
A focus on contraceptive preferences is essential to the provision of person-centered care. Adolescent girls and young women (AGYW) in the WHO African Region experience disparities in contraceptive access and use and reproductive health outcomes. Despite increasing recognition of AGYW needs as unique, their preferences are understudied, limiting strategies to improve contraceptive care access and quality among marginalized youth populations. We designed and conducted a discrete choice experiment among five hundred 15-20-year-old AGYW in Kisumu, Kenya, to examine the relative importance of trade-offs between contraceptive methods and service delivery attributes. Participants answered eight choice sets including three alternatives: two hypothetical contraceptive options characterized by seven attributes (effectiveness, bleeding pattern, duration of use, privacy, access location, counseling source, and cost) and a "no method" opt-out. We used random-parameters logit models to estimate preference weights and trade-offs among alternatives. The bleeding pattern was the most important determinant of stated choice, with a strong preference for unchanged or irregular bleeding over heavier bleeding or amenorrhea. Participants preferred the lowest chance of method failure as well as the longest duration of use (one year) over daily use or use during/after sex. Parous AGYW were more likely to prefer the longest duration of use. The ability to keep method use completely private was also an influential choice, particularly among 15-17-year-olds. AGYW traded effectiveness and increased cost for preferred bleeding patterns and privacy. The opt-out "no method" alternative was chosen only 2.7 percent of the time, indicating a strong preference for pregnancy prevention. Our findings highlight key insights for enhancing the person-centeredness of contraceptive care for AGYW: Kenyan AGYW place a high value on preferred menstrual bleeding patterns, high method effectiveness, longer duration of use, and the ability to keep method use private. Preference data can inform programs, including contraceptive decision-support interventions, to improve AGYW access to quality preference-sensitive contraceptive services.
Contraceptive Care Visit Objectives and Outcomes: Evidence From Burkina Faso, Pakistan, and Tanzania.
Moucheraud C, Wollum A, Brooks M … +3 more , Shah M, Gipson J, Wagner Z
Stud Fam Plann · 2024 Dec · PMID 39627833 · Full text
Globally, care experiences of the growing population of contraceptive users are not well-understood. We leverage a large client dataset (n = 71,602) from three countries (Burkina Faso, Pakistan, and Tanzania) to characte...
Globally, care experiences of the growing population of contraceptive users are not well-understood. We leverage a large client dataset (n = 71,602) from three countries (Burkina Faso, Pakistan, and Tanzania) to characterize contraceptive services sought (visit objective and method preference), assess whether these visit objectives were met and for whom, and explore if visit objective fulfillment was associated with care quality. Most people in all three countries said they were seeking to continue their current method or adopt a method for the first time. Clients seeking to change their method were least likely to have their objective met: 63.7 percent of clients in Burkina Faso, 73.3 percent in Pakistan, and 61.1 percent in Tanzania who wanted to switch actually achieved this during the visit. In Burkina Faso, people with lower socioeconomic standing, lower educational attainment, and lower parity less commonly had their switching objective, fulfilled. Method preference fulfillment was generally high, although approximately 15 percent of Tanzanian clients were given implants despite wanting another method. Among those seeking to adopt or restart a method in Pakistan and Tanzania, having this visit objective fulfilled, was correlated with better perceived treatment and higher person-centeredness of care.
Estimating the Social Visibility of Abortions in Uganda and Ethiopia Using the Game of Contacts.
Giorgio M, Shiferaw S, Makumbi F … +7 more , Seme A, Kibira SPS, Nabukeera S, Anjur-Dietrich S, Yihdego M, Tadele N, Sully E
Stud Fam Plann · 2024 Dec · PMID 39533531 · Full text
Social network-based data collection methods that rely on third-party reporting have emerged as a promising approach for measuring abortion in restrictive settings. In order for these methods to accurately measure aborti...
Social network-based data collection methods that rely on third-party reporting have emerged as a promising approach for measuring abortion in restrictive settings. In order for these methods to accurately measure abortion incidence, they must also assess the visibility of abortions within social networks. Failure to do so may result in estimates affected by transmission bias, caused by imperfect knowledge of all abortions within one's social network. In this paper, we present exploratory research that uses respondent-driven sampling (RDS) and the game of contacts method to measure abortion visibility in four sites in Uganda and Ethiopia. We assess the existence of potential biases in the game of contacts estimate of abortion visibility in each site by conducting several internal and external validity tests. While these tests provided some promising results, other factors such as the representativeness of the RDS samples, direct versus indirect abortion knowledge transfers, and the generalizability of the study sites may have introduced biases into the final estimates of abortion visibility in this study. We conclude by making recommendations on how applications of this methodology could be improved to better estimate abortion-related transmission bias.
Women's Perspectives on the Unique Benefits and Challenges of Self-Injectable Contraception: A Four-Country In-Depth Interview Study in Sub-Saharan Africa.
Himes E, Suchman L, Kamanga M … +29 more , Birabwa C, Gitome S, Omoluabi E, Okumu S, Nmadu G, Kwena Z, Liu J, Challa S, Amongin D, Wekesa P, Ndunyu L, Bukusi E, Malata A, Atuyambe L, Nyando M, Okoli C, Tijani A, Vallin J, Jegede A, Dimowo S, Maluwa A, Alitubeera P, Kaudha B, Kayego A, Jumbe T, Mtalimanja I, Waiswa P, Phillips B, Holt K
Stud Fam Plann · 2024 Dec · PMID 39511950 · Full text
Implementing self-injection (SI) of subcutaneous depot-medroxyprogesterone acetate (DMPA-SC) is a key self-care strategy for sexual and reproductive health, but SI uptake remains low, and assertions about the potential o...
Implementing self-injection (SI) of subcutaneous depot-medroxyprogesterone acetate (DMPA-SC) is a key self-care strategy for sexual and reproductive health, but SI uptake remains low, and assertions about the potential of SI to increase women's control over contraceptive use lack evidence. We sought to qualitatively explore how women with diverse contraceptive experiences-including those with and without experience using SI-view the benefits and challenges of SI as compared to other methods. We conducted 241 in-depth interviews with women across four sub-Saharan African countries and found alignment between the perceived and experienced benefits of SI across our diverse sample. Through the benefits of privacy, easier access, and self-management, we found SI can promote greater control over the contraceptive experience by facilitating a woman's ability to act on her preferences and control who is involved in or aware of her contraceptive use. Interviews revealed SI's potential is, however, constrained by inherent limitations in the method; for example, it is often not private or accessible enough and many fear injecting themselves. SI has the most potential when implemented with programmatic solutions that mitigate challenges women experience or anticipate and allow more women to benefit from the privacy, easier access, and self-management that SI offers.
Searching for Needles in a Haystack: Exploring Alternative Operational Approaches to Classify the Safety of Induced Abortions Using Respondent-Driven Sampling Data From Two Sub-Saharan African Settings.
Owolabi OO, Rossier C, Compaore R … +7 more , Kim C, Ganatra B, Ouedraogo R, Zan M, Bangha M, Baguiya A, N‐MAS team
Stud Fam Plann · 2024 Dec · PMID 39325587 · Full text
This study aims to describe the circumstances under which women obtained abortions in two sites, explore more nuanced approaches to classify abortion safety and examine the relationship between safety and self-reported h...
This study aims to describe the circumstances under which women obtained abortions in two sites, explore more nuanced approaches to classify abortion safety and examine the relationship between safety and self-reported health outcomes. We analyze data on the most recent abortion or only abortion reported by 551 women in Nairobi slums and 479 women in rural Kaya ages 15-49 years within the three years preceding the study, recruited via respondent-driven sampling. Using the most liberal safety classification, there were very few safe abortions (8 percent in Nairobi and 5 percent in Burkina Faso). A significant proportion of women reported using unidentified pills which we hypothesize may be medication abortion. Although a smaller proportion of women with safe abortions reported side effects, more of them reported side effects suggestive of infections and sought care for their symptoms. It is important that we explore and move towards more nuanced global safety classifications that more accurately reflect the risk associated with different methods and can capture women's access to comprehensive abortion care and its impact on their health.
Men's Willingness to Use and Preferences for Novel Male Contraceptive Methods in Malawi.
Gottert A, Mathur S, Gnofam M … +3 more , Sailer J, Pulerwitz J, Haddad LB
Stud Fam Plann · 2024 Sep · PMID 39118313 · Publisher ↗
Evidence is needed in low- and middle-income countries regarding men's willingness to use new male contraceptive methods in development, preferences regarding method attributes, and what shapes willingness/preferences. W...
Evidence is needed in low- and middle-income countries regarding men's willingness to use new male contraceptive methods in development, preferences regarding method attributes, and what shapes willingness/preferences. We analyzed data from cross-sectional surveys with 611 men in Malawi, concerning willingness to use each of four types of new male methods. Mean age was 24.5 years; half (50 percent) were married/cohabiting. Over half (51 percent) of men expressed willingness to use at least one new male method, including a topical contraceptive gel (33 percent), injection (32 percent), pill (29 percent), and implant (14 percent). Many male product attributes were considered important (with 59-67 percent endorsement), including ease of use, comfort of use, side effects, partner approval, type of method, frequency of facility visits, and cost. A prevalent reported reason for willingness was to "share responsibility for family planning with my partner" (44 percent). In multivariate regression analyses, willingness was inversely associated with inequitable gender attitudes (p < 0.001) and was not associated with married/cohabiting status, using condoms, or perceived risk for HIV. These findings add to growing evidence that a majority of men express willingness to use new male contraceptive methods like a topical gel, injectable, or pill. Reflection around gender roles is likely critical within future education about male contraceptive methods.
The Reliability of Contraceptive Discontinuation Reporting in Burkina Faso, Kenya, and Uganda.
Sarnak D, Magalona S, Anglewicz P
Stud Fam Plann · 2024 Dec · PMID 39090968 · Publisher ↗
Family planning researchers have been studying the discontinuation of contraception-the prevalence and reasons for it-for decades, as it has implications for contraceptive prevalence, total fertility, and unintended fert...
Family planning researchers have been studying the discontinuation of contraception-the prevalence and reasons for it-for decades, as it has implications for contraceptive prevalence, total fertility, and unintended fertility. However little is known about the reliability of contraceptive discontinuation reporting: only two studies have examined the reliability of reported discontinuation in low-resource contexts. We use longitudinal and overlapping data from reproductive calendars to test the reliability of women's reporting of contraceptive discontinuation in Burkina Faso, Kenya, and Uganda. We test whether recent discontinuations reported at baseline are reported one year later, and if the same reason for discontinuation is reported. Results reveal moderate reliability at the aggregate level of reporting of the index discontinuation; however, reliability is low when the timing of discontinuation is considered. There is variability across the reliability of reasons for discontinuation; discontinuation due to desired pregnancy is reported reliably while other reasons are less reliably reported. Our findings have important implications for the field, particularly in how the data are used and interpreted; we urge caution around event-level analyses of contraceptive discontinuation and reasons for discontinuation, given low reliability.
Unwanted Family Planning Including Unwanted Sterilization: Preliminary Prevalence Estimates for India.
Karra M, Canning D
Stud Fam Plann · 2024 Dec · PMID 39080878 · Full text
Estimates of unwanted family planning (UFP), which are based on a desire to have a child in the next nine months among current contraceptive users, exclude women who are sterilized since these women are not asked about t...
Estimates of unwanted family planning (UFP), which are based on a desire to have a child in the next nine months among current contraceptive users, exclude women who are sterilized since these women are not asked about their fertility preferences; all sterilized women are assumed to have a "met need" for family planning. However, the India National Family Health Survey asks sterilized women if they regret being sterilized and whether they were told that the operation would result in their permanent inability to have children. We extend the concept of UFP by classifying sterilized women who express regret or who were not informed about the procedure's permanence, as having UFP. When limiting our analysis of UFP to nonsterilized contraceptive users, we find that 0.9 percent of Indian women had UFP in 2019-2021. In this period, 29.9 percent of Indian women were sterilized. We estimate that 4.9 percent of sterilized women express regret and 16.3 percent were not told of the procedure's permanence. Adding sterilized women who express regret raises our UFP estimate in India to 2.3 percent, while also including sterilized women who were not told about the procedure's permanence yields an overall UFP estimate of 6.9 percent in India.
Assessing Trends in the Desire to Avoid Pregnancy: A Cautionary Note.
Casterline JB, El-Zeini L, Ibitoye M
Stud Fam Plann · 2024 Sep · PMID 39044337 · Full text
The desire to avoid pregnancy-to delay the next birth or have no further births-is a fundamental sexual and reproductive health indicator. We show that two readily available measures-prospective fertility preferences and...
The desire to avoid pregnancy-to delay the next birth or have no further births-is a fundamental sexual and reproductive health indicator. We show that two readily available measures-prospective fertility preferences and the demand for contraception [Demand] construct-provide substantially different portraits of historical trends. They also yield correspondingly different assessments of the sources of contraceptive change. We argue, with supporting empirical evidence, that Demand enormously overstates the historical trend in the desire to avoid pregnancy because Demand as currently constructed is in part a function of contraceptive prevalence. This makes for "reverse causality" in decompositions of contraceptive change, producing an upward distortion on the order of 25 percentage points in the amount of contraceptive change attributed to a change in fertility desires. Decomposition of contraception change free of the distortion reveals that contraceptive change has been due almost entirely to more complete implementation of fertility preferences. This is explained in part by the surprisingly slight historical change in preferences, a fact we document and then show is a consequence of a historical shift in parity composition toward lower parities.
Are Contraceptive Method Preferences Stable? Measuring Change in the Preferred Method among Kenyan Women.
Cardona C, Sarnak D, Gemmill A … +3 more , Gichangi P, Thiongo M, Anglewicz P
Stud Fam Plann · 2024 Sep · PMID 39010650 · Publisher ↗
Contraceptive preferences are important for reproductive outcomes, such as contraceptive continuation and pregnancy. Current approaches to measuring reproductive preferences in population surveys are limited to exploring...
Contraceptive preferences are important for reproductive outcomes, such as contraceptive continuation and pregnancy. Current approaches to measuring reproductive preferences in population surveys are limited to exploring only fertility preferences and implicitly assume that contracepting people are using a method they want. We know that people change their fertility preferences over the life course as a response to life events, but there is no information about changes in contraceptive preferences, given the limited evidence about the measurement and distribution of contraceptive preferences. In this study, we examined the extent of change in women's contraceptive preferences over one year and identified characteristics associated with this change in Kenya using three rounds of nationally representative longitudinal data. Over one year, 18 percent of contraceptive users and 46 percent of contraceptive nonusers reported changes in their preferred contraceptive. Experiencing a pregnancy or birth and changes in marital status were associated with changes in contraceptive preferences for users and nonusers. We found that contraceptive preferences are dynamic, suggesting that family planning programs should ensure people's access to various methods to respond to women's changing circumstances and preferences.
The Global Adolescent Fertility Decline is Counteracted by Increasing Teen Births in Sub-Saharan Africa.
Spoorenberg T, Carlsen EØ, Flatø M … +2 more , Stonawski M, Skirbekk V
Stud Fam Plann · 2024 Sep · PMID 39008442 · Publisher ↗
There is a lack of understanding of the persistence of elevated teen fertility rates in certain regions and countries, in contrast to the significant decline observed in other regions globally. This report considers fert...
There is a lack of understanding of the persistence of elevated teen fertility rates in certain regions and countries, in contrast to the significant decline observed in other regions globally. This report considers fertility trends among 15- to 19-year olds in the period 1950-2020 and explores potential driving factors behind the significant shifts that occurred over this period. The countries where teen fertility remains high are those with fast-growing populations, primarily located in sub-Saharan Africa. Countries with higher teen fertility are typically characterized by limited use of modern contraception, lower education levels, and early marriage. Sub-Saharan Africa has emerged as the world region with the most teen births, increasing its proportion of global teen births from 12 percent in 1950 to 47 percent in 2020, a time during which this region's share of the global adolescent (15-19) population grew from 7.5 percent to 19 percent. By 2035, 67 percent of all teen births globally are projected to occur in this region. Consequently, the future number of births to teenage mothers will to a large extent depend on the development in sub-Saharan Africa over the coming decades.
There's an App for That: Exploring the Market for Contraceptive Fertility Tracking Apps in the Philippines.
Danna K, Harris DM, Rothschild CW … +3 more , Brogaard B, LaCroix E, Paudel M
Stud Fam Plann · 2024 Jun · PMID 38851886 · Publisher ↗
For generations, women have relied on fertility awareness methods to plan and prevent pregnancy, for over a decade, many have been aided by digital tools to do so. New contraceptive fertility tracking apps (CFTAs)-that a...
For generations, women have relied on fertility awareness methods to plan and prevent pregnancy, for over a decade, many have been aided by digital tools to do so. New contraceptive fertility tracking apps (CFTAs)-that are backed by clinical efficacy trials to support their effectiveness as contraception-have the potential to enhance method choice and offer users a unique contraceptive option, but there is little evidence to inform the decisions around expanding access, particularly in low-and middle-income countries. We conducted a mixed methods study with quantitative online surveys (n = 1600) and qualitative interviews (n = 36) to explore the potential appeal of and demand for a hypothetical CFTA in one such market, the Philippines. Interest in using a CFTA was high among our Internet-engaged, urban study population, with 83.9% "definitely" or "probably" interested in using it. Across demographic profiles, respondents perceived the appeal of the method as "natural" and "convenient." A majority were willing to pay for the method, though notably at a price (5.20 USD) below that of currently available CFTAs. We discuss various important factors to be considered before bringing a method like this to new markets, including the potential implications of equity constraints in reaching a wider market and the unexpected prevalence of other period-tracking apps not intended as contraception being used in this market that could complicate any future roll-out. These issues could be explored further with additional research.
Continuation of Reversible Contraception Following Enrollment in the Zika Contraception Access Network (Z-CAN) in Puerto Rico, 2016-2020.
Zapata LB, Kortsmit K, Curtis KM … +6 more , Romero L, Hurst S, Lathrop E, Acosta Perez E, Sánchez Cesáreo M, Whiteman MK
Stud Fam Plann · 2024 Jun · PMID 38659169 · Full text
The Zika Contraception Access Network (Z-CAN) provided access to high-quality client-centered contraceptive services across Puerto Rico during the 2016-2017 Zika virus outbreak. We sent online surveys during May 2017-Aug...
The Zika Contraception Access Network (Z-CAN) provided access to high-quality client-centered contraceptive services across Puerto Rico during the 2016-2017 Zika virus outbreak. We sent online surveys during May 2017-August 2020 to a subset of Z-CAN patients at 6, 24, and 36 months after program enrollment (response rates: 55-60 percent). We described contraceptive method continuation, method satisfaction, and method switching, and we identified characteristics associated with discontinuation using multivariable logistic regression. Across all contraceptive methods, continuation was 82.5 percent, 64.2 percent, and 49.9 percent at 6, 24, and 36 months, respectively. Among continuing users, method satisfaction was approximately ≥90 percent. Characteristics associated with decreased likelihood of discontinuation included: using an intrauterine device or implant compared with a nonlong-acting reversible contraceptive method (shot, pills, ring, patch, or condoms alone); wanting to prevent pregnancy at follow-up; and receiving as their baseline method the same method primarily used before Z-CAN. Other associated characteristics included: receiving the method they were most interested in postcounseling (6 and 24 months) and being very satisfied with Z-CAN services at the initial visit (6 months). Among those wanting to prevent pregnancy at follow-up, about half reported switching to another method. Ongoing access to contraceptive services is essential for promoting reproductive autonomy, including supporting patients with continued use, method switching, or discontinuation.
Effects of Performance-Based Financing on Availability, Quality, and Use of Family Planning Services in the Democratic Republic of Congo: An Impact Evaluation.
Drouard SHP, Brenner S, Antwisi D … +4 more , Toure NK, Madhavan S, Fink G, Shapira G
Stud Fam Plann · 2024 Jun · PMID 38627906 · Publisher ↗
Access to high-quality family planning services remains limited in many low- and middle-income countries, resulting in a high burden of unintended pregnancies and adverse health outcomes. We used data from a large random...
Access to high-quality family planning services remains limited in many low- and middle-income countries, resulting in a high burden of unintended pregnancies and adverse health outcomes. We used data from a large randomized controlled trial in the Democratic Republic of Congo to test whether performance-based financing (PBF) can increase the availability, quality, and use of family planning services. Starting at the end of 2016, 30 health zones were randomly assigned to a PBF program, in which health facilities received financing conditional on the quantity and quality of offered services. Twenty-eight health zones were assigned to a control group in which health facilities received unconditional financing of a similar magnitude. Follow-up data collection took place in 2021-2022 and included 346 health facility assessments, 476 direct clinical observations of family planning consultations, and 9,585 household surveys. Findings from multivariable regression models show that the PBF program had strong positive impacts on the availability and quality of family planning services. Specifically, the program increased the likelihood that health facilities offered any family planning services by 20 percentage points and increased the likelihood that health facilities had contraceptive pills, injectables, and implants available by 23, 24, and 20 percentage points, respectively. The program also improved the process quality of family planning consultations by 0.59 standard deviations. Despite these improvements, and in addition to reductions in service fees, the program had a modest impact on contraceptive use, increasing the modern method use among sexually active women of reproductive age by 4 percentage points (equivalent to a 37 percent increase), with no significant impact on adolescent contraceptive use. These results suggest that although PBF can be an effective approach for improving the supply of family planning services, complementary demand-side interventions are likely needed in a setting with very low baseline utilization.
Confirmatory Factor Analysis and Validation of the Sexual and Reproductive Empowerment Scale for Adolescents and Young Adults in Kenya.
Zia Y, Upadhyay U, Rhew I … +7 more , Kimanthi S, Congo O, Onono M, Barnabas R, Mugo N, Bukusi EA, Harrington EK
Stud Fam Plann · 2024 Jun · PMID 38604945 · Full text
Understanding the levels of power that adolescent girls and young women exercise in their sexual and reproductive lives is imperative to inform interventions to help them meet their goals. We implemented an adapted versi...
Understanding the levels of power that adolescent girls and young women exercise in their sexual and reproductive lives is imperative to inform interventions to help them meet their goals. We implemented an adapted version of the Sexual and Reproductive Health Empowerment (SRE) Scale for Adolescents and Young Adults among 500 adolescent girls and young women aged 15-20 in Kisumu, Kenya. We used confirmatory factor analysis (CFA) to assess factor structure, and logistic regression to examine construct validity through the relationship between empowerment scores and ability to mitigate risk of undesired pregnancy through consistent contraceptive use. Participants had a mean age of 17.5, and most were students (61 percent), were currently partnered (94 percent), and reported having sex in the past 3 months (70 percent). The final, 26-item CFA model had acceptable fit. All subscales had Cronbach's alpha scores >0.7, and all items had rotated factor loadings >0.5, indicating good internal consistency and robust factor-variable associations. The total SRE-Kenya (SRE-K) score was associated with increased odds of the consistent method used in the past three months (adjusted odds ratio: 1.98, 95 percent CI: 1.29-3.10). The SRE-K scale is a newly adapted and valid measure of sexual and reproductive empowerment specific to adolescent girls and young women in an East African setting.
Evaluation of Emergency Contraceptive Pill Use with Health Management Information Systems Data in Pakistan.
Farid S, Mohammed K, Bietsch K … +1 more , Emmart P
Stud Fam Plann · 2024 Mar · PMID 38483790 · Publisher ↗
According to the WHO, all clients should have access to a range of contraceptive methods, including at least one short-term, one long-term, one permanent, and one emergency method of contraception. While there are data o...
According to the WHO, all clients should have access to a range of contraceptive methods, including at least one short-term, one long-term, one permanent, and one emergency method of contraception. While there are data on the contraceptive method mix available for many low- and middle-income countries, there are limited data on emergency contraception (EC). This is likely due to some surveys not routinely collecting this information, how survey questions are asked, dual method use, and/or low levels of reported use of EC pill (ECP). Even with low reported use in surveys, contraceptive social marketing statistics from DKT International. show a trend in recent years of increasing product sales of ECPs. To understand a more complete scope of ECP use, we use Pakistan as a case study and analyze Pakistan's Demographic Health Survey (DHS) surveys and Pakistan's Contraceptives Logistics Management Systems. Based on commodities dispensed data for ECPs in 2021, about 0.4 percent of all married women in Pakistan use ECPs. While there is currently a small proportion of women, it is growing and the use of ECPs is not zero as indicated by the DHS. Therefore, where available, countries should review their health management information systems data alongside survey data for ECP use.
[Not Available].
Stud Fam Plann · 2024 Mar · PMID 38446453 · Publisher ↗
Abstract loading — click title to view on PubMed.
The Relationships between Drought Exposure, Fertility Preferences, and Contraceptive Behaviors: A Multicountry Study.
Somefun O, Banougnin BH, Smith-Greenaway E
Stud Fam Plann · 2024 Mar · PMID 38414154 · Publisher ↗
The interplay between population dynamics and the environment has long interested demographers. Although studies have explored how climate patterns affect macrolevel population processes, such as mortality and migration,...
The interplay between population dynamics and the environment has long interested demographers. Although studies have explored how climate patterns affect macrolevel population processes, such as mortality and migration, little is known about their impact on individual-level demographic behaviors. This study fills this research gap by examining the linkages between exposure to drought and women's fertility preferences and contraceptive behaviors in sub-Saharan Africa. We analyze data from the Demographic and Health Surveys Program, focusing on 17 countries in East, Southern, and West Africa. We investigate whether women's recent exposure to drought episodes in their community affects their fertility preferences and modern contraceptive use. Generally, the findings show that drought is relevant to understanding women's fertility preferences and behaviors in the vast majority of countries; however, drought exposure has variable impacts. Moreover, whereas in some countries, drought exposure encourages contraceptive behaviors that align with women's preferences, in select countries it is associated with behavior that is misaligned with women's stated preferences. Overall, the study emphasizes the importance of examining climate events as complex forces that have localized meanings for demographic outcomes.
Child Fostering and Family Size Preferences in Uganda.
Cotton C
Stud Fam Plann · 2024 Mar · PMID 38351477 · Publisher ↗
Mothers who exceed their ideal family size (IFS) may find themselves caring for more children than desired. In the absence of reliable and desirable prenatal controls of family size, mothers may foster-out children to re...
Mothers who exceed their ideal family size (IFS) may find themselves caring for more children than desired. In the absence of reliable and desirable prenatal controls of family size, mothers may foster-out children to reduce burdens of childrearing, particularly in contexts where fostering is common. Using six rounds of Demographic and Health Surveys collected in Uganda between 1988 and 2016, I explore the relationship between exceeding IFS and child out-fostering, proposing that fostering-out may serve to manage excess fertility and that this relationship may change as actual and desired fertility declines. Models are run separately for mothers and children aged 0-17 to explore mothers' overall out-fostering behavior versus out-fostering strategies for children. Results at the mother level suggest a strong positive relationship between exceeding IFS and out-fostering that remains relatively stable over time, but results at the child level indicate children's age explains the relationship between mothers' exceeding IFS and being fostered-out, demonstrating the nuances of how family size preferences might impact family life in practice. Though mothers report a desire for smaller families over time, childbearing and childrearing behaviors, including high fertility and child out-fostering, remain consistent over the course of Uganda's fertility transition, signifying the central role out-fostering plays in Ugandan families.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe