The conflicting effects of delayed marriage and declining divorce rates on cumulative fertility in Indonesia.
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Biomedical subjects
Publications and source records attributed to J A Palmore.
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Contraceptive use and method mix were analysed using Philippines national survey data of 1973, 1978, and 1983. The analyses suggest that the reported decline in contraceptive prevalence between 1978 and 1983 was due to under-reporting of use in 1973 and 1983. The shifts in contraceptive method mix were also partly from under-reporting of rhythm and other methods in 1973 and 1983. Nevertheless, the determinants of method choice were similar in all three sets of data. Filipino couples were making rational choices in terms of their contraceptive goals, access, evaluation, and competence. Modifications in the directions and magnitude of the relationships in determining method choice also occurred, partly reflecting the increased use of sterilization by older, higher parity women.
The straightforward tests we have conducted lead to two major conclusions. First, parameter estimates, such as the proportions that practice contraception or that breastfeed, can be biased in data restricted to the last closed and open interval. This is particularly true the further back in time one goes. However, the second conclusion is that these restrictions do not bias estimates of the structure of the relationships predicting fertility. This may seem surprising, and perhaps even magical. The reason is that multivariate life table techniques allow one to reach the same conclusion even if the proportions in various categories are altered by a criterion such as limiting the analysis to intervals begun by the last and next-to-last live births. Limiting the analysis in this way means that there are fewer short intervals and thus fewer cases of intervals with characteristics associated with short intervals (e.g., no contraceptive use, no breastfeeding, or infant mortality). As long as the model specified in the multivariate life table is an appropriate one, that is, it is not misspecified, and as long as the skew produced by the WFS restriction is not too extreme, then the multivariate life table procedures can produce unbiased estimates of the structure of the relationships predicting birth interval dynamics. Thus even though the WFS data are in fact inappropriate for some simple parameter estimation procedures, they appear to be adequate for the more complex multivariate procedures of the sort used here. Several caveats must be added to the foregoing results. First, we have performed this test in only one country, Korea; it is possible that the same results might not be obtained in other countries. We expect, however, that they would. Second, our procedure only looks at the first 40 months of experience in the birth interval. A procedure that incorporates the long tails of the birth interval distribution may obtain different results. In fact, we caution against analyzing the tail of the distributions using data from the normal WFS sample, since these would be most affected by the restriction to last closed and open intervals. Third, the extent to which these results are generalizable to other types of substantive problems is unknown at present. We suspect, however, that examining the determinants of lengths of breastfeeding will produce similar results. Finally, even with multivariate procedures, it would be highly misleading to impose the WFS restrictions and then examine trends in the length of birth intervals.(ABSTRACT TRUNCATED AT 400 WORDS)
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This analysis compares the effects of contraceptive use and infant and fetal mortality on the pace of fertility in Korea and the Philippines and explores the mediating effects of these intermediate variables on educational differentials in childspacing. For both intervals initiated in a recent period before a sample survey, second, third and higher-order intervals are examined. Transitions within successive segments of interval exposure (qx values) are examined rather than cumulative transitions (1 - lx values). This methodological choice is substantively important because breastfeeding should primarily affect early segments of exposure and because it allows empirical examination of the timing of the effects of other variables such as contraceptive use. Further, this choice allows multivariate analysis within the structure of the life-table perspective. The results show substantial differences in patterns between Korea and the Philippines, indicate clearly the effect of each intermediate variable, and illustrate how educational differentials in fertility are affected by contraception and infant and fetal mortality.
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Reducing medical complications resulting from induced abortion by identifying the safest and most appropriate procedures(s) for each gestational age is the purpose of this study. Data on all women who had induced abortions at all hospitals in the State of Hawaii where such procedures were performed between March 11, 1970, when the new abortion law went into effect, and June 30, 1974 were analyzed. Study findings show that if the abortion procedure with the least risk of complications at each length of gestation were selected a reduction in the complication rate of nearly 30% could result.
Although contraceptive practice has increased substantially in Korea as a result of a strong national family planning program, surveys indicate the existence of an additional unmet demand. A number of obstacles tend to limit availability of family planning services and supplies. The effects of total availability are being tested in a three-year experiment in household contraceptive distribution, for which an exploratory study was carried out in 1975 in Euiryong gun. Three distribution systems were tried in three areas of Euiryong, each enlisting local women to canvass and distribute pills and condoms (and refer those desiring IUDs or sterilization to physician). Results of the preliminary test showed that household distribution was culturally acceptable and administratively feasible and that it did increase contraceptive use. Cost-effectiveness was considered to be within the range of the national program. The most successful of the three distribution systems is being applied in the main study, begun late in 1976 in Cheju province.
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The characteristics of Korean family planning opinion leaders are assessed through a secondary analysis of the 1971 national survey conducted by the Korean Institute for Research in the Behavioral Sciences. In effect, what characterized Korean family planning opinion leaders was a rather national and democratic model. Those who had tried methods, discussed them, and knew a lot about them assumed leadership roles more than others. Place of residence, education, and other such variables mattered relatively little unless a woman had credibility imparted by actual use and knowledge imparted by use or discussions with family planning professionals.