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PubMed1997

[Contraception in adolescents included in a family planning program].

OBJECTIVE: To describe the motives of consultation, kinds of contraceptive methods and side-effects of oral contraceptives (OCs) in adolescent users of a family planning program. DESIGN: Family planning program at the District Primary Care Unit, Cádiz, Spain. PATIENTS: 283 adolescent females who requested attendance in a family planning program from January 1993 until January 1994. MEASUREMENTS AND MAIN RESULTS: A medical history of every adolescent was carried out and every patient was examined. Those who were recommended the use of OCs passed through 3 controls: at the beginning, after the 6th month and after 1 year. These controls consisted in recording sexual risk behaviours as well as several analytic tests. RESULTS: Most adolescents requested the prescription of contraceptive methods (81.7% of the most prescribed and demanded methods were OCs). We found no serious side-effects after 1 year, so we can conclude that OCs are an usefull contraceptive choice for sexually active adolescents because of its security, acceptance and easy use.

Adolescent↗
PubMedDate not supplied

Perceptions of population policy, development, and family planning programs in northern Nigeria.

In this article, local perceptions of family planning programs and federal population policy are examined, based on responses to a childbirth survey and on interviews with a range of individuals in one northern Nigerian town. The respondents' differing perceptions of the relationship between population and national development reflect distinctive ideas about political authority, population policy, and family planning programs, about development, and about domestic and international political affairs. Local suspicions about the Nigerian population policy and family planning programs suggest that they cannot be implemented in isolation from broader political and economic concerns. This distrust has ramifications for current family planning programs and reproductive health initiatives undertaken by Western-sponsored aid projects.

Adolescent↗
PubMedDate not supplied

U.S. organized family planning programs in FY 1974.

Most organized family planning programs combine the delivery of contraceptive services with a wide range of preventive health services. An estimated 3.3 million women, 97 percent of all who received family planning services in organized programs in FY 1974, received one or more medical services. At least 2.7 mission women received each of the 'core' medical services recommended by DHEW -- pap smear, blood pressure and pelvic and breast examinations. About 2.4 million women were tested for VD; 2.1 million women received urinalyses and 1.9 million received blood tests. Other services provided included pregnancy testing, infertility workup, and rubella and sickle cell screening.

Adolescent↗
PubMed1978

A components method for measuring the impact of a family planning program on birth rates.

One of the major goals of family planning programs worldwide has been to reduce the level of fertility in hopes of slowing the rate of natural increase and promoting social and economic development. Such programs have now been in existence for sufficient lengths of time to have had an impact on fertility levels. In general countries with organized family planning programs, marked declines in fertility levels have been observed. The extent to which such declines may be credited to organized programs has not been rigorously measured because an appropriate research methodology has been lacking. This paper describes one method of directly linking declines in fertility levels to the contraceptive protection experienced by a population. The contribution of organized family planning programs is estimated by decomposing the amount of total contraceptive protection into within-program and outside-program sources.

Age Factors↗
PubMed1976

Colposcopy screening for cervical cancer in a family planning program.

A brief history is presented of colposcopy in the United States and at Louisiana State University. Incorporation of colposcopy screening as a part of the cervical cancer screening program in the Louisiana Family Planning Program is discussed, and the reasons for the need of "in house" colposcopy service are outlined. Data of the Louisiana Family Planning Program Colposcopy Service for the three-year period 1972 through 1974 are presented. Analysis of these data reveals that cytology when used without colposcopy fails to reveal the presence of major cervical pathology in 30.2% of patients. It is concluded that colposcopic screening must be a part of all family planning and cervical cancer detection programs.

Colposcopy↗
PubMedDate not supplied

Cost-effectiveness analysis of family planning programs in rural Bangladesh: evidence from Matlab.

The Family Planning Health Services Project in Matlab is often seen as more expensive than similar activities carried out by the government of Bangladesh. At the same time, it as been observed that the project is much more effective. The alleged high cost of the project is said to make it difficult to replicate throughout the nation. Previously, the true costs of the project had not been documented. This study systemically examines the cost of the project and assesses its cost-effectiveness. An experimental design framework is used as a basis for understanding the cost-effectiveness of the project, although a sensitivity analysis lends further support to the relative efficiency of the approach undertaken in Matlab. Although in the aggregate, the Matlab Project is more expensive than the government's family planning program, it is also more effective, generating enough output to offset the extra costs of the intensified delivery system.

Bangladesh↗
PubMedDate not supplied

Costs, payments, and incentives in family planning programs: a review for developing countries.

Anxieties about financing health and family planning programs have grown in recent years, leading to discussions of cost-recovery measures that would raise charges to the consumer. Yet some governments wish to lower cost to encourage contraceptive use, and a few use incentives and disincentives. Data from numerous developing countries are presented on contraceptive cost topics: charges for contraceptive supplies and services, in both public and private sectors, and conversely, payments made to clients and providers to offset costs and to increase contraceptive use. The data show great diversity, and much inconsistency within countries, indicating that the structures of charges, payments, and incentives in many programs could be improved. Ethical considerations are discussed, and guidelines are suggested for developing effective financial policies.

Contraception↗
PubMedDate not supplied

The contribution of social science research to population policy and family planning program effectiveness.

Social science research has made important contributions to population policy and to the effectiveness of family planning programs. Social science concepts, theories, and methods potentially are relevant to all aspects of reproductive behavior, including actual fertility, proximate variables, and desired family size. Social science research also contributes to the understanding of the social, economic, and political institutions that potentially affect, either directly or indirectly, the whole biosocial reproductive system and family planning programs. At least as important as its specific theories and findings is the role of social science in testing how to adapt such knowledge to distinctive national and local cultural circumstances of family planning programs. A central point is that carefully monitored pilot projects are desirable before launching full-scale national programs, as well as being continuing resources for program development. The research on early programs in Asia has been important, because those programs encountered and overcame some of the presumed obstacles to new programs.

Asia↗
PubMedDate not supplied

The demographic impact of family planning programs.

In response to concerns about the adverse consequences of rapid population growth, family planning programs have been implemented in many developing countries. The aim of the present study is to assess the impact of this programmatic approach on long-range population growth. The result of a new and hypothetical population projection indicates that in the absence of family planning programs the population of the developing world could be expected to reach 14.6 billion in the year 2100 instead of the 10 billion that is currently projected by the World Bank. Despite the apparent success of existing interventions, fertility control is far from complete, as many women continue to bear unwanted births. To assess the impact of this unintended childbearing a second hypothetical projection is made. With perfect implementation of reproductive preferences, the population size of the developing world in 2100 would be reduced by an estimated 2.2 billion below the current projection. Further strengthening of family planning programs and improvements in birth control technology are therefore likely to provide important demographic benefits.

Contraception Behavior↗
PubMed1988

[Fertility decline and consequences of the National Family Planning Program: an analysis of the achievements of family planning activities in Chiang Mai and Lamphun provinces].

Based on the census data of 1970 and 1980 for each province of Thailand, the present study has revealed that between 1960-1980, a rapid fertility decline took place in 17 northern provinces and 26 central provinces of Thailand. A similar rapid fertility decline also took place starting in 1975 in the 16 northeast provinces and in the 14 southern provinces. Levels and trends of fertility found in this study suggest that most of the districts in the northern and the central regions reached the replacement level or below by 1985, and that similar levels will be attained by 1990 for almost every district in Thailand. This paper also stresses the impact of the rapid fertility decline on development in Thailand during the past 20 years, and its consequences. Lastly, the present study suggests that, for the future, the most important step is to understand well the consequences of this astonishing rapid fertility decline. This knowledge will be vital for the country and its people.

Asia↗
PubMedDate not supplied

Community participation in national family planning programs: some organizational issues.

Increasing the involvement of communities in implementing national family planning programs has been advocated as a means of increasing the acceptability, availability, and sustainability of services provided. This article reviews the nature and extent of community participation in the national programs of Bangladesh, China, the Republic of Korea, the Philippines, and Thailand by analyzing the structures and processes through which participation is organized. Across all five countries a similar pattern of participation has emerged in which a community-based delivery system is supported by the involvement of community leaders in activities that promote family planning. Active participation in planning and management functions is, however, virtually nonexistent. This limited form of participation is attributed to the bureaucratic organization of national family planning programs that seek to implement policies with explicit demographic goals. Given these goals and organizational structures, however, the pattern of organizing participation observed is probably the most appropriate. Consequently, policymakers should be wary of expecting greater involvement by community members in program implementation activities or in contributing resources unless consideration is given to reorienting the goals and organizing programs that meet needs that are directly relevant to families and communities.

Attitude↗
PubMed1978

The McCormick Family Planning Program in Chiang Mai, Thailand.

The McCormick Family Planning Program is a private, single-purpose program that has been offering contraceptive services to women in largely rural Chiang Mai province in Northern Thailand since 1963. In addition to two clinics in Chiang Mai city, the program operates a mobile unit, which visits service points throughout the province. An injectable contraceptive, DMPA, has been selected by about two-thirds of program acceptors since 1965, despite its prevalent side effect of amenorrhea. The service generates sufficient revenues, from relatively low fees for sterilization and contraception, to cover most operating costs. The program is seen as successful in providing rural women with contraceptives services. Aspects of the program--particularly the use of DMPA and the mobile service unit--are considered replicable in other settings.

Adolescent↗
PubMedDate not supplied

Direct and judgmental measures of family planning program inputs.

This report compares two different approaches to measuring the strength of family planning programs in Bangladesh and Kenya. The first approach, the judgmental approach, has been used in a number of studies during the past two decades; scores on the characteristics of family planning programs are derived from the responses knowledgeable persons give to a series of questions. The second approach is to obtain direct measures of each item being considered. In Bangladesh, the total score varied trivially between the direct and the judgmental approaches. In Kenya, the total direct score was substantially higher than the judgmental score. The primary advantage of the judgmental approach is that comparative scores can be obtained for a larger number of countries for the same time period at a much lower cost than would be required by the direct approach.

Adolescent↗
PubMed2003

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.

Journal Article↗