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PubMed1991

Survey report: Jordan.

Preliminary results from the 1990 Jordan Population and Family Health Survey show a 20% decline in fertility since the early 1970s. The total fertility rate (TFR, or average lifetime births/woman) declined from 7.7 births in the 1971-1975 period, to 6.6 in 1980-1983, to 5.6 in 1987-1990. A national sample of 6462 evermarried women of childbearing ages were interviewed. More than 1/2 (58%) of respondents had ever used a method of contraception. 35% of married women reported currently using some method of contraception, up from 26% in 1983. The IUD was the most popular modern method--used by 15% of women. Female sterilization (6% of respondents) edged out the pill (5%). These findings show a shift in contraceptive use from the pill to the IUD and female sterilization compared with 1983. In general, older women, those living in big cities, women with a formal education, and those who have children are more likely to use contraception. Compared with other countries, the level of fertility in Jordan is high for the level of contraceptive use. Reliance on traditional methods may account for this difference: 27% were currently using modern methods and 8% traditional. Knowledge of contraceptive methods is high. Almost all women knew of at least 1 method of family planning, either modern or traditional. The pill and IUD were the best-known methods; 98% of the women knew at least 1 of these. The next best-known were traditional methods: periodic abstinence (77%) and withdrawal (69%). Most women who knew a family planning method also knew where to obtain it. For example, more than 94% of those surveyed knew about female sterilization, of whom 85% knew where to go to have it done. The survey showed infant mortality in Jordan had declined to 27/1000 livebirths. Almost all children under 2 had received some vaccinations, and almost all are breastfed for at least some time. There seems to be a strong program prompting diphtheria/pertussis/typhoid, polio, and measles vaccination in Jordan, according to the report. Of all children 12-23 months, 88% had received these vaccinations, although coverage declined with successive doses.

Asia↗
PubMed1993

A preference for baby girls.

For the majority of women in Japan, a girl baby is preferable to a boy baby, according to recent findings of a fertility survey conducted by the Institute of Population Problems of the Ministry of Health and Welfare (MOHW). The nationwide survey, carried out in July 1992, found that 75.7% of women would prefer to have a girl baby if they were to have only 1 child--a marked change from 10 years ago when only 48.5% of women said that they would prefer a girl child. Conducted every 5 years, the survey gained responses from 8844 married women under 50 years of age. In giving reasons for wanting a girl child, many women commented that a daughter is more likely to remain closer to parents than a son. The findings of the survey reflect the changes that have taken place in Japanese society in recent years including the emergence of the nuclear family, later marriage, fewer children, and population aging. The survey also found that only 15.2% of marriages currently follow the practice of omiai (arranged marriages), a sharp decrease from 23.6% of 5 years ago. Meanwhile, couples are waiting longer after their first encounter before getting married. According to the survey, couples married during the 1987-1992 period waited an average of 2.97 years after their first encounter, a sharp contrast from the average waiting period of 1.97 years for couples married between 1972-1977. The survey also found that while the total fertility rate has fallen in Japan to 1.50 in 1992 from 1.75 in 1980, fertility for married couples has remained virtually unchanged since 1972 at 2.21.

Asia↗
PubMed1988

Survey report: Senegal.

Senegal, situated on the west coast of Africa, has a history of high fertility and high infant mortality. Preliminary results of the 1986 Demographic and Health Survey (DHS), administered by the Institute for Resource Development, Columbia, Md., indicate a slight decline in the birth rate and reveal a high prevalence of child health problems associated with poor sanitation and nutrition. Senegal's 7.1 million people (1987 estimate) are unevenly distributed throughout the country's dry, flat landscape. Some 40% of the population is urban, and about 1/2 of these urban residents live in the capital, Dakar. Heavy rural-to-urban migration has been encouraged by the high population growth rate--2.8% annually--and a poor standard of living in the countryside. With about 70% of the labor force dependent on agriculture, a drought-related drop in the yields of groundnuts and other cash crops contributed to the rural exodus and to growing unemployment in the capital. The 1986 survey of family planning and child health collected information from 4415 women 15-49 years of age, and measured the height and weight of their children between 6 and 36 months. The findings suggest that fertility may have fallen slightly since 1978. The Senegal DHS recorded a total fertility rate (TFR) of 6.5 average births/woman during the 1981 Senegal World Fertility Survey (WFS). The DHS also found that women at the end of their childbearing--age 45-49 in 1986--had borne 7.4 children on average, further evidence of a slight decline in births among the younger women. Senegalese women marry young. The average age at 1st marriage is only 16.1, according to the 1986 DHS, and family planning within marriage is not widely accepted. In 1986, 11.7% of the currently married women 15-49 used some form of birth control, but only 2.7% used a modern method. While this is a large increase over the 3.9% rate of contraceptive use recorded in the 1978 WFS, almost 3/4 of the gain was due to a higher reported use of abstinence and withdrawal. In fact, 29% of the married women had relied on abstinence some time in the past, while only 6% had ever used a modern method. Current use of the pill and the IUD increased 4-fold between 1978 and 1986, but the 1986 level is still too low to have much effect on fertility rates. The knowledge of various contraceptive methods did increase significantly between 1978 and 1986. For example, only 18% of the married women said they were familiar with the pill in 1978, while 51% knew about it in 1986. In general, knowledge of modern contraceptives grew from 20%-68% of married women, while knowledge of traditional methods increased from 50-90%., between 1978 and 1986. When asked why they did not use contraceptives, 34% of the women said they were trying to become pregnant, and 19% said religious proscriptions against birth control discouraged them from using contraceptives. The preliminary DHS report also showed that 43% of the children under age 5 had vaccination cards, according to their mothers, although interviewers were able to verify the existence of cards for only 23% of the children. Up to 77% of the children under age 5 living in the Dakar region had vaccination cards (46% verified by interviewers), in marked contrast to the rest of the country.

Africa↗
PubMedDate not supplied

Contraceptive use and fertility in Honduras, 1981-84.

This paper presents data on contraceptive use and fertility in Honduras obtained from a household survey conducted in 1984, and compares these data with similar information obtained from surveys carried out in 1981 and 1983. About half of the increase that has taken place in contraceptive use in Honduras is accounted for by sterilization. In 1981, 27 percent of women in union aged 15-49 years were practicing contraception; in 1984, the percentage of those 15-44 was 35 percent. The increase in urban areas was smaller (from 47 percent to 51 percent) than in rural areas (from 16 percent to 24 percent). Also, fertility remained almost unchanged in urban areas while declining in rural areas. Information from questions on place of purchase, price, and brand of contraceptive (for orals) was used to determine source of supply. The use of multiple questions to determine source results in a higher percentage of contraceptive use attributed to the Honduran Family Planning Association as compared with answers to a single question. The duration of breastfeeding in Honduras has increased, with the greatest changes occurring among women in urban areas and women with the highest levels of education. Efforts have been made to promote breastfeeding in urban areas and these results suggest that the efforts have been successful.

Adolescent↗
PubMed1998

Impact of the October 1995 pill scare in Grampian.

Over two years have elapsed since the Department of Health issued a press release concerning the safety of some third generation contraceptive pills. Warnings about increased abortion rates followed and recently published national figures for England and Wales have confirmed this. In Grampian we have assessed the impact of the pill scare at a subnational level, which has received much less consideration. Grampian has a stable population with an estimated 116,500 women in the reproductive years. The six month period from November 1995 until April 1996 was chosen to monitor the immediate aftermath of the pill scare. Aberdeen Royal Infirmary provides a regional, dedicated abortion service and has maintained a service specific database since 1994. This is an ideal situation to monitor trends in abortion rates in a specific population. Women attending for abortion counselling were asked to complete a questionnaire regarding their recall of media publicity. Live-births at Aberdeen Maternity Hospital from June to November 1996 were also recorded, reflecting conceptions in the study period. Prescribing patterns for combined pills and emergency contraception for Grampian general practitioners and Grampian Healthcare family planning service were also analysed. There was no increase in the abortion rate in the study period when compared with the same period in the preceding year - a total of 728 women underwent an abortion. Forty six women were identified within the 728 as having conceived as a direct consequence of the scare, but their characteristics were not dissimilar to the other women on the database. Live-birth rates were also stable. Emergency contraception prescribing was slightly increased for the family planning service but not in general practice. Both general practice and the family planning service showed an immediate and sharp fall in prescribing of third generation pills mirrored by an increase in second generation pill prescribing. For family planning particularly, prescriptions for third generation pills have shown an increase again from early 1996, although remaining below original levels. Fifty five per cent of the women who were given the questionnaire about media publicity responded. Seventy nine per cent recalled some publicity, but 17 per cent of these women could not remember any specific details. Unlike national reporting, our figures do not substantiate any increase in abortions or deliveries in the aftermath of the pill scare. The slight increase in emergency contraception prescribing by the family planning service more probably reflects local awareness campaigns rather than any appreciable switch away from regular pill use. On a population level, the scare did not have the predicted negative impact on pill users in Grampian and it would have been incorrect for us to extrapolate from national data in this instance. Failure to demonstrate numerical impact for the population does not deny the devastating effect of a termination for an individual woman. The emotional impact of the scare on women, while more difficult to measure, should not be underestimated. The influence on the next generation of women with regard to their contraceptive choice remains to be seen.

Abortion, Induced↗