Evaluation of family planning and reproductive health programmes

In India, abortion is legal under Medical termination of Pregnancy Act Since 1971. As per the evidence, around 9% of total maternal deaths are caused by unsafe abortion. Though Medical Abortion (MA) drugs are prescription-only-products, in reality, it is often obtained without doctor’s prescription through pharmacists. The pharmacists often have limited knowledge of safe use of drugs that may result in complications. Population Services International’s intervention on safe medical abortion aims at educating pharmacists to improve their knowledge and dispensing practices related to MA drug regimen. Using Lot Quality Assurance Sampling method, a mystery client or simulated patient survey was conducted on MA drug Dispensing behaviour among 380 pharmacists. The study revealed that 55% of pharmacists recommended correct dose of MA drug and 45% pharmacists suggested correct route of administering MA drug, while only 25% of the pharmacists asked for doctor’s prescription for dispensing MA drug. The findings also revealed that only 42% of the pharmacists behaved correctly on all three key indicators (asked for doctors’ prescription, recommended correct dose and route for administration) pertaining to MA drug regimen. The study helped to identify the low performing areas for further attention by program managers.

The main aim of this paper is to assess the impact of at least one maternal healthcare service from three core components (antenatal care, institutional delivery, postnatal care) on contraceptive use. Data from the third wave of cross-sectional District Level Household Survey (2007-08) that covered 87,564 ever-married women aged 15-44 years in Uttar Pradesh have been analyzed. Results from the propensity score matching show that effects of utilizing at least one MH service (treatment) on contraceptive use (outcome) is statistically significant. The correlation coefficient among unobservable factors is also found to be significant. It indicates that variable for treatment variable created a selection bias while it was taken as one of the independent variables to predict likelihood of using a contraceptive method. Biprobit analysis shows that effects of using at least one MH service are positive and significant on likelihood of using a FP method. Likelihood of using a FP method also significantly varies by intensity of MCH services utilization and available community level factors. Reproductive health managers may use such dividends of utilization of MCH services in making family planning program strategies in rural Uttar Pradesh.

A central restructuring of intergovernmental relations following decentralization in Indonesia is, among others, about financial system. Unacceptable share of local Budget to family planning is widely occurring. Huge discrepancy is unavoidable. Specific Allocation Fund/SAF allows direct financing from central to the local government limited to finance physical infrastructure. It has been implemented since 2008 with persistent increase in its total budget covering 377 districts. This study aims to analyze the management of the SAF for family planning in 6 provinces during 2010-2011. The information derived from in-depth interviews and focus group discussions with various stakeholders at provincial and district levels as well as analysis of current SAF policy and secondary data. Along with the story that SAF provision gives “hope” to the districts, this financing system is temporary to the low resource settings. Even so no guarantee can be hold that rich districts will provide adequate budget for family planning program to survive. A boarder viewpoint need to be considered and the scheme of this financing need to be re-designed in such a way that this fund mechanism empowers districts to be more responsible in bringing the program adaptive to the local demand.

In China it is well known that the one child policy in urban area and 2+1 policy in rural region have been executed for a long time in order to control the population increase. forced abortions happened in many places of China, which cannot be accidental or just results of some personal behaviors. But it is indeed hard to explain from the demographic or sociology perspectives. Based on the materials collected from an in-depth interview study on the local government performance evaluation which conducted in Gansu province during July 2012, this paper tries to explain the occurrence of forced abortion and the local government’s dilemma in fulfilling its goal of family planning policy from the angle of public management. And suggests the main cause is the biased government performance evaluation system. According to the theories of government performance evaluation, the local family planning departments do not have public value oriented practice, which is rooted from the fault of inappropriate organizing model of the local government performance evaluation. The PV-GPG (Public Value-based Government Performance Governance) model is introduced to solve this issue and improve the current organizing mode.

Reproductive and Child Health indicators are very important for the improvement and maintenance of health for women and children in any society. This study examines differentials in institutional delivery, child immunization coverage and contraceptive use by religion and also investigates public and private share in institutional delivery and source of obtaining modern spacing methods by Muslim and non-Muslim in Muslim densely populated states and India using data from India's DLHS-3. This paper adopts bivariate analysis to study the differentials by selected background characteristics. In all the indicators, non-Muslims have shown their glorious pictures as compared to Muslims at the national level as well as in the selected states. Substantial differences have been also noticed in public and private share in institutional delivery and source of obtaining modern spacing methods. West Bengal and Assam show highest level of differences for all of the indicators. In backward states of Uttar Pradesh, Jharkhand and Bihar it has been seen that both Muslim and non-Muslim women are increasingly availing private institution for delivery instead of public institutions. This study may help planners or policy makers to formulate various types of policy which will be helpful to reduce the prevailing differences between them.

The present study aims to study the couple’s inconsistency with respect to their use of family planning and factor affecting their inconsistency. The data from National family Health Survey, 2005-06 has been used. Results from the study shows that, mismatching in reporting of current use is 20 percent. Reporting of use of male method, in 93 percent cases both reported same and in 4 percent cases only husband reported that he is using method and wife does not know about that. In 12 percent cases husband does not know that wife is using family planning. In 7 percent cases only wife is reporting that she is sterilized. From the logistic regression it is clear that, Odds of having mismatch are high in the couples who got married before 10 years as compared to those who marry recently in case of reporting of all methods and female methods; whereas in case of reporting of male methods it is showing reverse results. Likelihood of having mismatch is high in urban area. Education of the women has positive and significant effect on mismatching. Education of husband has positive effect on mismatching about male methods whereas it has negative effect on reporting of female methods. Odds of having mismatch are less in schedule tribe. As compared to poor class couple rich couples are more likely to misreport about male method use.

As an imperative to safe maternity in India, it’s the protocol to ANC care givers to explain the benefits and encourage pregnant women for institutional delivery. However, little attention has been paid to seek association between advice on institutional delivery and actual place of delivery. Using data from National Family Health Survey-3, present study aims to assess levels and differentials and seeks association between advice and actual place of delivery. Bivariate analysis shows that only 52% women were advised for institutional delivery. However, multivariate analysis points that those advised were 2.4 times (CI=2.3-2.6) more likely to go for institutional delivery. Likelihood of receiving advice was negatively associated with birth order but positively with mother’s education and wealth quintile. Huge differential by place of residence and region has also emerged. However, women from Southern region were 5.4 times (CI=4.93-6.01) more likely for receiving advice and 4.6 times (CI=4.16-5.17) more likely to go for institutional delivery. Results highlight non-uniform and poor service delivery and prioritize efforts to curb the lackadaisical attitude of ANC care givers on lines of southern region. It also calls to improve educational opportunities and economic status of women to narrow maternal and child deaths in future.

Studies on the causes of maternal mortality in India have focused on institutional deliveries, and the association of socioeconomic and demographic factors with the decline in maternal mortality has not been sufficiently investigated. By using both time series and cross-sectional data, this paper examines the factors associated with the decline in maternal mortality in India. Relative effects estimated by OLS regression analysis reveal that per capita state net domestic product (1.49611, p<0.05), poverty ratio (0.02426, p<0.05), female literacy rate (0.05905, p<0.10), infant mortality rate and total fertility rate (0.11755, p<0.05) are statistically significantly associated with the decline in the maternal mortality ratio in India. The Barro regression estimate reveals that improvements in economic and demographic conditions such as growth in state income (β=0.35020, p<0.05) and reduction in poverty (β=0.01867, p<0.01) and fertility (β=0.02598, p<0.05) have a greater association with the decline in the maternal mortality ratio in India than institutional deliveries (β=0.00305).

Although reproductive health advocates consider family planning programs the interven- tion of choice to reduce fertility, there remains a great deal of scepticism among economists as to their effectiveness, despite little rigorous evidence to support either position. This study explores the effects of family planning in Ethiopia using a novel set of instruments to control for potential non-random program placement. The instruments are based on ordinal rankings of area characteristics, motivated by competition between areas for resources. Access to family planning is found to reduce completed fertility by more than 1 child among women without education. No effect is found among women with some formal schooling, suggesting that family planning and formal education act as substitutes, at least in this low income, low growth setting. This provides support to the notion that increasing access to family planning can provide an important, complementary entry point to kick-start the process of fertility reduction.

Abstract


One of the most important problem faced by Indonesia in carrying out development is a matter of demography. Population problem is an extremely important and complex, particularly for developing countries and has a large population. The general objective of national development is trying to reduce poverty and raise the level of community life. Goals and expectations will be difficult to realize in the development process is carried out, especially if the population problem is still not resolved properly.
The main objective of this research is to provide demographic and socioeconomic profiles of respondents ever married women from Indonesia Demographic and Health Survey (IDHS) 2007. Information based on background characteristics of respondents in the survey is important in order to explain the findings presented in this report. This study begins by presenting background characteristics of respondents according to age, educational level, age of first marriage and area of residence. In addition, employment data are presented as measured with the field work respondents. The population in this study are: Elligible couple interviewed on IDHS Year 2007 in West Nusa Tenggara Province. The sample in this study were ever married women who are still married and aged 15-49 in West Nusa Tenggara Province