Contraceptive use dynamics in developing countries

This paper examines the impacts of socioeconomic development, status of women and family planning on contraceptive practice and the extent to which these effects vary among rural and urban areas in Bangladesh. The Logit model will be used to evaluate the effects of a selected group of variables on the probability of reproductive behavior of rural and urban women in Bangladesh. By comparing the reproductive behavior of the rural women to those of urban women, we will be able to discern whether these differences can be explained by differing compositional characteristics with respect to socioeconomic development and status of women in rural and urban populations. We will also be able to establish whether the differences in reproductive behavior of rural and urban women are diverging, converging or remaining the same. Decomposition techniques will also be used to delineate factors that may have contributed to the observed rural-urban differences in reproductive behavior in Bangladesh.

The ICPD represented a “quantum leap” for population and development policies as it involved a paradigm shift from the previous emphasis on Demography and Population Control to Sustainable Development and Reproductive Rights. Earlier, TFR and CPR used to be the fixation of most population programme. But a revamp in the Family Welfare Programme, from the earlier approach of provider centric-target oriented approach to client centered-target free approach now all couples to decide freely on number, spacing, and timing of childbearing. This paper examines the change in patter of use of family planning methods and the socio-economic- demographic & program factors that influences couples desire to space between children and hence shift from adopting permanent method to reversible methods by using service statistics and survey data in last three decades. There is a clear trend in shifting from acceptance in limiting methods to spacing over time. The timing of limiting and stopping or spacing behaviour is mainly determined by the couple’s desired family size, number of surviving children, sex composition of surviving children and other motivating factors such as cost, demand, opportunity, and individual costs. India is more informed on spacing and thus the re positioning of family planning helps to ‘India Shining’.

Background: Chitungwiza urban PMTCT programme has shown an increase in the number of known HIV-positive pregnant women enrolling in antenatal care (ANC). In 2009, 116 (8.4%) out of 1,376, booked for ANC with known HIV-positive status and in 2010 they were 79 (11.1%) out of 712. It was not known whether these pregnancies were planned or unplanned.

Methods: A descriptive, cross-sectional study was conducted in Chitungwiza from April-September 2011. Multi-gravida women enrolled in the PMTCT programme with known HIV-positive status (n=170) were interviewed using an interviewer-administered questionnaire and focus group discussions of 10-15 women. Quantitative data was analysed using Epi- Info Version 3.3.

Results: Of the 170 respondents, 137 (80.6%) experienced unplanned repeat pregnancies. Reasons for becoming pregnant varied: 75 (44.1%) reported their pregnancy was due to pressure from their partner, 32 (18.8%) were denied the right to use contraception by partners or health workers and 87 (51.2%) respondents could not afford these methods.

Conclusion: The HIV-positive women in this study faced challenges in controlling their fertility and experienced unplanned pregnancies. Chitungwiza municipality should waive fees for contraceptives and make long-acting and permanent FP methods freely available.

I take advantage of the gradual phase out of USAID’s contraceptive donations to the Philippines from 2004 to 2008 as a natural experiment that severely disrupted publicly-provided contraceptive supply. Prior to this, more than two-thirds of the country’s contraceptive users relied on free supplies from the public sector, which in turn relied entirely on donations from international agencies like USAID. Because it succumbed to pressure from the Catholic church, the national government did not fill the shortage that occurred. While it devised a progressive allocation schedule for the distribution of the declining supply of free contraceptives to the provinces, the actual distribution was erratic and intermittent due to shipment delays, inventory miscalculations, and lumpy deliveries induced by round lot sizes. Utilizing substantial geographic and temporal variation in the share of women age 15-49 that had provisions for free contraceptive supplies at the province-quarter level, this research looks into the short-run fertility impact of the contraceptive supply disruption. Results show that a demonstrable linkage exists between diminishing contraceptive supply from the public sector and higher birth rates, especially for the poor and the less educated, which suggests that couples’ compensating behavior may be limited or incomplete.

In many developing countries, use of the private sector for healthcare, even among the poor, is high. Yet data on private health providers such as their total number and the types of services they provide is often limited. This paper presents results from a unique data collection effort carried out in Lagos and five other states of Nigeria in which all private health facilities in these states were identified and surveyed. At each facility, data was collected on the physical infrastructure, the types of services offered, and the quality of family planning services delivered at the facility. We first present lessons from the data collection effort itself and provide useful suggestions for others seeking to conduct similar exercises elsewhere. We then analyze the geographic distribution of private providers, the type of services they provide, and the quality of family planning practices delivered by private providers in these states.

Objective: To examine association between social economic attributes (often reported at macro-level) and contraceptive use
Methods: Data were accrued from the Ugandan baseline survey of a multi-country three-year prospective study focusing on the role of family planning on Family Health and Wealth. A total of 500 couples were enrolled in Kyengera-parish, Wakiso district, Uganda.
Inequalities defined as differences in population attributes (wealth, ethnicity, health status-BMI category, parity, education and occupation) were assessed for association with contraceptive use (Yes/No). Analysis used descriptive statistics and at bivariate and multivariate, generalized linear models using binomial family and a log link with robust standard errors to obtain Prevalence Risk Ratios (PRRs) and their 95% CI.
Results: Data of 499 couples are presented. Men were older than women, 34 (7.9) and 27 (6.5) years, respectively. Majority (70%) of women reported being in monogamous unions, of parity 2 or higher (70%), education level of secondary or higher (67%), involved in manual or clerical work (71%) and belonging to Christian-faith (66%). Contraceptive prevalence rate was 52%, and was significantly higher among parity of 2 or higher. Health status, household wealth and education level were not associated with contraceptive use

Knowledge of Family Planning: Are Tribals better off than non-tribals: A case from India
Abstract
The paper was based on knowledge and practice of modern methods of Family Planning among Tribals and Non-Tribals population of Jharkhand state of India. The research questions were (i) Are tribals marginalized with respect to knowledge on family planning methods? (ii)Are tribal males and females more knowledgeable of the family planning methods than non-tribal?” (iii) Is knowledge related to practice of family planning methods among the tribal and non-tribal population?
The study was a cross sectional study conducted in 11 villages from each of the districts. In total 33 villages were covered. A sample of 274 males and 268 females was covered for the study. The sample was distributed across respondents as per parity. Frequency distribution and chi square was used to analyze the findings.
This paper attempts to show that more than the caste one belongs to, it the status of that caste in the community which determines whether they get marginalized status or not. In a society, where so called marginalized community, that is scheduled caste and scheduled tribe is in majority, their fate is better both relatively and comparatively to the other community.
The Key terms are Tribal, Non-Tribal, Family Planing, Knowledge & Practice

In Bangladesh, fertility was high in the 1950s and declined to fewer than five births per woman in the early or mid-1990s like other developing countries. After that the level of fertility is stalled. The aim of this study is to assess the extent of unmet need for family planning among married women of reproductive age group in Bangladesh and to study the factors related to it. Bangladesh Demographic and Health Survey data were used for the study. The results suggest that unmet need for family planning has increased during the last 3 years from time of the survey. The percentage of total unmet need is especially high among rural women, non working women, Muslim women, and women not exposed to media messages on family planning. The regression analysis shows that age, husband-wife communication, sex composition and visitation status of satellite clinic appear to be significant predictor for limiting unmet need. If we can reduce the current unmet need to zero then current met need will be 73 percent which is the required rate of achieving replacement fertility in Bangladesh. New program strategies are required to fulfill the conventional demand for family planning program in Bangladesh.

This study aims to investigate the determinants of female sterilization in Brazil. Our analysis is innovative because it adds the time of exposure to the risk of sterilization into survival models. We control the models by postpartum duration, age at delivery, parity at delivery, place of delivery, region of residence, color/race, years of schooling, frequency of involvement in religious activities, and religion at the time of interview. We use data from the 2006 Brazilian National Survey on Demography and Health of Women and Children (PNDS). The strongest probability that sterilization might occur was observed among women who gave birth at private hospitals and received support from a health insurance company, between zero and two months after childbirth. These results are an indication of a frustrated demand for female sterilization at public hospitals. Unlike previous studies, our findings suggest color/race and years of schooling do not predict the risk of sterilization.

Modern Contraceptives (MC) are useful for limiting fertility and protection against STIs including HIV/AIDS. MC are not easily accessible in most developing countries where high proportion of the people earns below 1$/day. This study examines the gap in MC use between women in the richest and poorest wealth quintile. It utilized Malawi Demographic and Health Survey dataset, 2010 and examined 5085 and 2290 married women aged 15-49 who met the inclusion criteria set for ever use of modern contraceptives (EUMC) and current use of modern contraceptives (CUMC), respectively. Chi-square and logistic regression were used for the analysis (α=5.0%). Mean CEB of the women in the poorest (3.94±2.7) was higher than their counterparts in the richest (2.82±2.3) wealth quintile (p<0.0001). About 76% of the women EUMC; with 66.8% and 82.4% EUMC in the poorest and richest wealth quintile respectively (p<0.0001). The prevalence of CUMC was 53.8% and was significantly higher among richest (58.5%) than the poorest (45.9%). Poorest married women were less likely 0.423(C.I=0.371-0.482) and 0.601(C.I=0.507-0.713) to EUMC and CUMC respectively than their counterparts in the richest wealth quintile. These odd ratios vaguely vary even when other potential confounding variables were used as control.