Contraceptive use dynamics in developing countries

Female sterilization has been the dominant method of family planning in India since the early 1980s. We use data from various government publications and three rounds of the Indian National Family Health Survey conducted in India in 1992-93, 1998-99 and 2005-06 to examine the trends and patterns in the use of female sterilization in India. We also aim to investigate whether or not there has been any change in the profile of acceptors of female sterilization in India over the last two decades. Furthermore, an attempt will also be made to examine the births averted due to female sterilization in India and in the major states of India. Finally, we will examine the quality of female sterilization services and post-sterilization regret associated with female sterilization. Appropriate bivariate and multivariate techniques will be used to fulfil the objectives of the paper. We propose to use the method suggested by Liu et al. (2008) for estimating the births averted due to female sterilization.

This study examines the level and predictors of condom use among sexually active married women (15-49 years) in their last extramarital sex. The most recent standard DHS data for Congo Brazzaville, Ghana, Malawi and Namibia are analysed. Results indicate that condom use in extramarital sex in the sample ranges between 6.4% (Ghana) and 26.6% (Namibia). Predictors of using condom in extramarital sex include higher wealth quintile, husband living with wives, employment, tested for HIV/AIDs, knowledge of condom usage reducing risk of HIV, higher years of schooling and age at first marriage (odds ratios range from 1.04 to 6.57, P<0.01/0.05). However, older women and those in female headed households are less likely to report condom use during extramarital sex. Elevating socioeconomic status of women is an imperative and sexual health educators should focus on older women and those in female headed households on the importance of using condom during extramarital intercourse.

Introduction: Though family planning program effort continues in countries where replacement levels have not been reached, with progressive program efforts comes the question of “where” to improve further- which needs a continuous re-evaluation.
Data: This study mainly utilizes contraceptive calendar data from latest Demographic and Health Survey done in 2005-06 in India.
Methodology: The study employs an innovative application of semi-Markov modeling technique using TreeAge software 2012 to simulate and analyze the dynamics of contraceptive behavior among rural poor Indian women and offer programmatic insight. Monthly transition probabilities for the model were obtained by survival analysis techniques using Stata 10.
Results: The study model simulates contraceptive behavior of the sample population and provides comprehensive estimates. More importantly, it shows the futility of focusing on any single aspect of contraceptive behavior in achieving demographic goal. The study demonstrates the interdependence between the two by revealing the change in relative importance and magnitude of impact of various aspects of contraceptive use behavior on mean number of pregnancies in an atmosphere of constantly changing contraceptive behavior mix.

A study of 960 currently married women from Jharkhand and Chhattisgarh indicated that majority of women were young and illiterate. Chhattisgarh women were more literate than Jharkhand women. Two-third currently married women in Jharkhand and half in Chattisgarh were not offered any method choice during the contraceptive acceptance process. One third in Jharkhand and half in Chhatisgarh were informed about the side effects while adopting a method. Currently married women in Chhattisgarh were more likely to receive information about the side effects of different methods of contraception than those in Jharkhand during the contraceptive acceptance process. Half of sterilization users had received follow up after sterilization. Younger women received more follow-up services. Education did not show definite association with reported utilization of follow up services. A few women used herbal methods too .It has emerged during the qualitative interactions that most popular method of family planning was sterilization. Majority of women used pills and IUD but male sterilization was not prevalent. Some of the most frequently quoted issues related to different methods were that sterilized women sometimes gain weight and women using pills and IUD face problems of abdominal pain, white discharge and irregular menstruation.

Traditional Medicine (TM) has responded to healthcare-delivery needs of Africans for decades. However TM means different-things-to-different people. Equally, TM as sexual remedy has received limited attention. Therefore, this study examined TM as paradigm shift in promotion of sexual medicine in sub-Saharan Africa.
The study adopted quantitative/qualitative data collection methods, and was descriptive and cross-sectional in design comprising 800 respondents. The FGDs and questionnaires data were analysed thematically and statistically respectively.
A total of 20.5% of participants under herbal addiction used TM to prevent infection during sex. Few (3.0%) used herbs and concoction (6.3%) to increase sexual performance. Moreover, (1.5%) suggested that herbal concoction could improve sexual health. Most (60.3%) postulated visiting traditional healers herbal use (10.3%) and drug-taken (17.3%) would provide prevention/treatment against STDs. FGD participants unanimously believed in TM efficacy than contraceptive-use. Hence Magun could prevent diseases while Ale enhances ejaculation and sperm-production Aseje boost sexual-performance. Most African people used traditional herbs to enhance sexual performance
There is need to support clinical investigation of TM especially the claims in relation to sexual health improvement

Family planning is most inexpensive intervention to empower poor women of the world to exercise their rights to better sexual and reproductive health. Despite the dramatic increase in contraceptive use in last four decades, in many populations still the unmet need remains high due to lack of Government commitment and poor accessibility of contraception. The main objective of this paper is to understand the levels and trends in unmet need for family planning and contraceptive prevalence rate (CPR) among poor and non-poor. Further, changes in overall fertility and fertility preferences among poor and non-poor in selected Asian countries namely: Bangladesh, India, Indonesia, Nepal, Philippines and Vietnam. Three rounds of most recent DHS data for each country (except Vietnam) have been analyzed for the study. Selected Asian countries are in different stages of fertility as well as family planning transition. Preliminary results suggest that, unmet need as well as TFR is comparatively higher among poor women compared to their non-poor counterparts. It is also observed that TFR, mean ideal family size and desire for additional child have declined irrespective of economic status over time probably due to the increasing CPR and diffusion of idea of perceived benefits of small family size.