Repositioning family planning

The Connect Project in Tanzania a strategy for scaling-up a field trial to become a national program. It operationalizes and evaluates the impact of a community-health worker program aimed at reducing child mortality through community-based primary healthcare services, including case management of childhood diarrhea, pneumonia and malaria. It commenced in 2011 as a randomized controlled trial with features to study the effects of implementation on health systems strength. Faced with high unmet need for contraception in the study population, Connect has integrated family planning into its primary health care operation. This is scaling up the program in phases guided by evidence. In the current paper, findings from a formative micro-pilot and qualitative case study impart lessons learned and clarify the determinants and processes of successfully integrating family planning into the Connect service system. Evidence from operations research demonstrates the relative quality, productivity and coverage achieved by the intervention in settings where family planning has been integrated and not. An end of project multi-level impact analysis is presented that projects the impact of distance to service point on fertility in areas exposed and unexposed to Connect services, forecasting fertility impact if results are extended to scale.

Kenya was the first Sub-Saharan African country to initiate a national family planning programme way back in 1967; however, contraceptive use still remains low and the unmet need for family planning has remained at 25 per cent over the years. This paper uses data from Kenya demographic and Health Survey of 2008-09 to examine differentials in contraceptive use among women in Kenya by method type. The sample is restricted to currently married women and current method of choice. Preliminary results indicate that women prefer to use short-term hormonal methods such as pills and injectables. This can be seen across regions, type of place of residence, education levels, wealth quintiles, and religion. However with regard to age groups, only women in the age range 45-49 prefer to use long term methods such as sterilization, implants etc. This implies that women may be using short term methods for the purpose of spacing births rather than limiting births. This has implications on further fertility reductions in the country. The issue of informed choice and method availability in facilities may also determine the type of method used. Paper is still in progress

This paper uses data from the 2000 and 2004 Demographic and Health Surveys to examine the factors explaining the contraceptive method choice in Malawi. Multinomial logistic regressions were used to study the determinants of the contraceptive method-choice. The results show that the major determinants of contraceptive use are age, respondents’ and partners’ approval of family planning, family planning discussion with partner, number of living children, work status, education and visit to a health centre. As a policy measure, information, education and communication programmes on family planning should be intensified, particularly in rural areas and targeting men.

Key words: Malawi, Contraceptive use, logistic regression, socio-economic, Demographic and health survey

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.

Students are currently enrolled in primary schools, middle schools, high schools, and universities in the two communities. The data also touch upon the students’ current family size, parents’ family size, families’ Socio-Economic Status (SES), Parents’ occupations, educational levels, parents’ number of siblings, desired age of marriages well as parents’ place of birth.

At the core of this study is the assumption that population policies have indeed affected the size of the current families, thus the observed decline in birth rates in the respective countries. Moreover, the authors suggest that the effect of the population policies upon the next generation of parents could be ascertained by measuring their attitudes regarding the “expected” number of children as reflected in their responses to the notions of ideal, likely, and realistic number of children envisioned for themselves.

Our data suggest a direct relationship between the sample students’ expected family size and the current Total Fertility Rates (TFR) observed in the respective countries. The socio-economic impact of our findings with some surprising results will be discussed as well.

Understanding the flow of resources to reproductive health and family planning is essential for an effective repositioning of these key health components at the country level. This paper gives a comprehensive picture of the challenges in reproductive health (RH) and family planning funding in Kenya. Data are drawn from the RH sub-accounts for the financial years 2005/6 and 2009/10 and from The Resource Flows Project surveys. The results show a significant increase in population assistance to Kenya over a period of 10 years, but a significant decrease in the percentage of funds allocated to reproductive health. Results from the RH sub-accounts indicate that reproductive health receives little attention within the government budgets despite its contribution to the MDGs, that the public sector is the largest financier of RH services and that household spending on RH is very high. The study suggests that Kenya needs to increase spending on RH in order to achieve the MDGs. Besides, safety nets for the poor are needed to reduce the burden of RH spending on households.

Although the international family planning program at USAID had enjoyed priority attention and funding from its inception in the 1960s until the time of the Cairo Conference in 1994, by 2001, its funding had stagnated at low levels for five years; the Mexico City Policy had been imposed; HIV/AIDS was gaining ascendancy in funding within the Agency; and both fertility levels and modern contraceptive prevalence rates (MCPR) in several sub-Saharan African (SSA) countries were stagnating. Some scholars even suggested that the international family planning movement was at the stage of fragmentation and decline. Consequently, USAID in collaboration with the World Health Organization and other partners began an initiative to reposition family planning in SSA. Within ten years, the initiative had achieved numerous impressive results: the annual funding for family planning at USAID increased by over 50%; MCPR saw unprecedented increases in several SSA countries; increased funding commitments were coming in from host country governments and international donors; and family planning now enjoys greater visibility and is recognized as a key variable for economic development. This paper’s goal is to explain the strategies adopted by USAID to reposition family planning, discuss the key achievements, and highlight the challenges that remain

Sexual behaviour among young people is characterized by erratic, infrequent and unplanned sexual activities, a trend that exposes them to unwanted pregnancy and sexually transmitted infections including HIV. While sexual activity among young women begins early, contraceptive knowledge and use remain low. According to the Kenya Demographic & Health Survey, 2008-09, current contraceptive use (modern methods) among women aged 15-19 and 20-24 is 5% and 24% respectively. Existing communications were mainly targeted at married women, highlighting the need to limit family size or space births, thereby causing a disconnect with the youth whose needs are mainly to delay child bearing. To provide credible information that will dispel myths and misconceptions about modern family planning methods (MFPMs) and use, this paper seeks to: 1) understand method specific myths and misconceptions about MFPMs; 2) recommend appropriate approaches to inform behaviour change communication targeting young women.

The contraceptive use is not only the family planning program but also the strategy to increase women empowerment. Previous studies in Indonesia mostly focused on male participation in family planning, but litle is known about the role of women in decision making for family planning. Therefore, this paper aims to explore disparity in contraceptive use among Indonesian regions by exploring women’s role.
This paper used the 2007 Indonesian Demographic and Health Survey. The sample included 18,183 currently married women aged 15-49 years old. The contraceptive use refers to as using the modern method. The crucial independent variable was combination of gender and decision making. Other control variables were characteristics of women, characteristic of husbands, number of children, and residences. The descriptive statistics, the geographic information system application and logistic regression were applied.
It was found that there was a disparity in contraceptive use between areas and women decision making played an important role in increasing contraceptive use. In addition other variables could help to increase the use of contraception.
The results from this study suggested that to increase women empowerment would reduce disparity in contraception across the country.

About 200 million women of reproductive age in developing countries have unmet need for contraception (unmet need). Family planning is key in achieving Millennium Development Goals (MDGs). It can among other things, curb the AIDS pandemic and reduce infant mortality. Zambia’s unmet level of 27% is higher than the average for sub-Saharan Africa. Understanding correlates of unmet need is crucial to reducing the risk of having unmet need. Previous studies have largely ignored community factors and yet these are more effective policy informing instruments. The study used the 2007 Zambia Demographic Health Survey to examine the role of community- level determinants in explaining differentials in unmet need among currently married women. In view of the nested nature of the data, the study employed the multilevel analytic technique. About 38% of the women belonged to the Bemba/Mambwe ethnic group. The percentage of those with secondary or higher education was 26.9%. Unmet need was highest among women with primary education (66.5%). Rural women had more unmet need compared to urban ones. The random effects at the community level were 47%. There are big differences in unmet need across communities. Therefore, there is need to contextualise family planning services in Zambia.