1.  Peer Reviewed Title: Unmet need for contraception among HIV-positive women in Lesotho and implications for mother-to-child transmission. Author: Adair T Source: Journal of Biosocial Science. 2009 Mar;41(2):269-78. Abstract: In Lesotho, the risk of mother-to-child-transmission (MTCT) of HIV is substantial; women of childbearing age have a high HIV prevalence rate (26.4%), low knowledge of HIV status and a total fertility rate of 3.5 births per woman. An effective means of preventing MTCT is to reduce unwanted fertility. This paper examines the unmet need for contraception to limit and space births among HIV-positive women in Lesotho aged 15-49 years, using the 2004 Lesotho Demographic and Health Survey. HIV-positive women have their need for contraception unmet in almost one-third of cases, and multivariate analysis reveals this unmet need is most likely amongst the poor and amongst those not approving of family planning. Urgent action is needed to lower the level of unmet need and reduce MTCT. A constructive strategy is to improve access to family planning for all women in Lesotho, irrespective of HIV status, and, more specifically, integrate family planning with MTCT prevention and voluntary counselling and testing services. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | KAP SURVEYS | DEMOGRAPHIC AND HEALTH SURVEYS | MULTIVARIATE ANALYSIS | URBAN POPULATION | WOMEN IN DEVELOPMENT | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | KNOWLEDGE | CONTRACEPTION | NEEDS ASSESSMENT | BIRTH SPACING | POVERTY | ATTITUDES | PROGRAM ACCESSIBILITY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Data Analysis | Population Characteristics | Economic Development | Economic Factors | Disease Transmission Control | Prevention and Control | Diseases | Sociocultural Factors | Family Planning | Evaluation | Socioeconomic Factors | Psychological Factors | Behavior | Program Evaluation | Programs | Organization and Administration Document Number: 331114 |
| 2. Peer Reviewed Title: Contraceptive use, birth spacing, and autonomy: an analysis of the Oportunidades program in rural Mexico. Author: Feldman BS; Zaslavsky AM; Ezzati M; Peterson KE; Mitchell M Source: Studies in Family Planning. 2009 Mar;40(1):51-62. Abstract: Oportunidades, a conditional cash-transfer program instituted in Mexico in 1997, provides cash incentives to mothers to invest in the health and education of family members. Drawing from data gathered by Mexico's National Institute of Public Health, this study assesses the effect of the program on contraceptive use and birth spacing among titulares (female household heads) living in rural areas during the experimental period, 1998-2000, and during 2000-03, after incorporation of the control group. In 2000, titulares were more likely to use modern contraceptives than were women in the control group, although by 2003 all beneficiaries had the same probability of use. Change in autonomy was not a mediator, although baseline autonomy modified the program's influence on contraceptive use. Cox proportional hazard models produced estimates that birth spacing was similar between the beneficiaries and controls. Inconsistent findings may be the result of the way contraceptive use was defined in this study. Findings from this study may be useful for helping program planners better understand the role of conditional cash transfers in modifying family planning and fertility among poor rural women in Latin America. Language: English Keywords: MEXICO | RESEARCH REPORT | KAP SURVEYS | LONGITUDINAL STUDIES | MATHEMATICAL MODEL | CASE CONTROL STUDIES | RURAL POPULATION | MOTHERS | WOMEN IN DEVELOPMENT | HEAD OF HOUSEHOLD | BIRTH SPACING | CONTRACEPTIVE USAGE | INCENTIVES | HOME ECONOMICS | North America | Americas | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Theoretical Models | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Economic Development | Economic Factors | Households | Family Planning | Contraception | Policy | Political Factors | Microeconomic Factors Document Number: 331287 |
| 3. Title: Reconsidering childhood undernutrition: can birth spacing make a difference? An analysis of the 2002-2003 El Salvador National Family Health Survey. Author: Gribble JN; Murray NJ; Menotti EP Source: Maternal and Child Nutrition. 2009 Jan;5(1):49-63. Abstract: It is well understood that undernutrition underpins much of child morbidity and mortality in less developed countries, but the causes of undernutrition are complex and interrelated, requiring a multipronged approach for intervention. This paper uses a subsample of 3853 children under age 5 from the most recent family health survey in El Salvador to examine the relationship between birth spacing and childhood undernutrition (stunting and underweight). While recent research and guidance suggest that birth spacing of three to five years contributes to lower levels of infant and childhood mortality, little attention has been given to the possibility that short birth intervals have longer-term effects on childhood nutrition status. The analysis controls for clustering effects arising from siblings being included in the subsample, as well as variables that are associated with household resources, household structure, reproductive history and outcomes, and household social environment. The results of the multiple regression analyses find that in comparison to intervals of 36-59 months, birth intervals of less than 24 months and intervals of 24-35 months significantly increase the odds of stunting (<24 months Odds Ratio (OR) = 1.52; 95% confidence interval (CI): 1.21-1.92; 25-36 months OR = 1.30; 95% CI: 1.05-1.64). Other factors related to stunting and underweight include standard of living index quintile, child's age, mother's education, low birthweight, use of prenatal care, and region of the country where the child lives. Policy and program implications include more effective use of health services and outreach programs to counsel mothers on family planning, breastfeeding, and well child care. Language: English Keywords: EL SALVADOR | RESEARCH REPORT | ANTHROPOMETRY | CHILDREN | CHILD HEALTH | CHILD DEVELOPMENT | CHILD NUTRITION | BIRTH SPACING | BIRTH INTERVALS | LOW BIRTH WEIGHT | FAMILY PLANNING | BREASTFEEDING | NEEDS | PROGRAM EVALUATION | Developing Countries | Central America | Latin America | Americas | Measurement | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Biology | Nutrition | Fertility Measurements | Fertility | Population Dynamics | Birth Weight | Body Weight | Physiology | Infant Nutrition | Economic Factors | Programs | Organization and Administration Document Number: 329593 |
| 4. Title: Childbearing and contraceptive decision making amongst Afghan men and women: a qualitative analysis. Author: Haider S; Todd C; Ahmadzai M; Rahimi S; Azfar P; Morris JL; Miller S Source: Health Care For Women International. 2009 Oct;30(10):935-53. Abstract: Afghanistan has one of the highest maternal mortality ratios and lowest contraceptive prevalence rates globally. Limited information is known regarding Afghan men and women's attitudes toward childbearing, child spacing, and contraceptive use, which is essential for delivery of appropriate services. We conducted a qualitative study among postpartum couples enrolled at maternity hospitals in Kabul, Afghanistan. We identified important themes that highlight the complex inter-relationship between acknowledged risks of childbearing, desire for family planning, rationales for limited contraceptive use, and sociocultural barriers to contraceptive use. We offer practical recommendations for application of findings toward family planning and maternal mortality reduction programs. Language: English Keywords: AFGHANISTAN | RESEARCH REPORT | QUALITATIVE RESEARCH | MEN | WOMEN | COUPLES | POSTPARTUM | DECISION MAKING | BIRTH SPACING | REPRODUCTIVE BEHAVIOR | CONTRACEPTIVE USAGE | SOCIOECONOMIC FACTORS | FAMILY PLANNING PROGRAMS | Asia, Southern | Asia | Developing Countries | Research Methodology | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | Puerperium | Reproduction | Behavior | Family Planning | Fertility | Population Dynamics | Contraception | Economic Factors Document Number: 342710 |
| 5. Title: Methods for Female Contraception: A Model for Innovation in Drug Delivery Systems. Author: Merkatz R; Tokay B; Sitruk-Ware R Source: Clinical Pharmacology and Therapeutics. 2009 May;85(5):553-557. Abstract: In 2007, 1.7 billion women were in need of contraception, but only 57% of them were using modern contraceptives.1 During a woman's 30-year reproductive life, her contraceptive needs may vary from postponing childbearing to spacing out the births of her children and, finally, to limiting family size. Modern contraceptive methods and their delivery systems reflect these changing needs as well as the challenges associated with the long-term regulation of conception, which are similar to the challenges encountered in developing therapeutics for chronic medical conditions. The lessons learned during the development of modern contraceptive methods may be relevant to the development of therapeutics for chronic medical conditions requiring treatment throughout the life cycle. Despite advances in contraception, many women who wish to avoid pregnancy either choose not to use contraception, do not have access to a suitable method, or use a method incorrectly resulting in millions of unintended pregnancies each year accompanied by significant morbidity and mortality. Clearly, improvements in methods have contributed to the increased use of contraception worldwide, but current user-controlled methods could be further improved to promote greater adherence. It would be helpful to ease restrictions on access to medical care and contraceptive supplies because such restrictions limit the use of contraceptives, particularly the longacting, reversible methods that are associated with higher rates of compliance. Further advances in the field of contraception will require targeted development of new and improved methods combined with country-specific changes in policy and funding in order to ensure access to these methods. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | WOMEN | CONTRACEPTION | DELAYED CHILDBEARING | BIRTH SPACING | CONTRACEPTIVE METHODS | CONTRACEPTION RESEARCH | PROGRAM ACCESSIBILITY | Developed Countries | North America | Americas | Demographic Factors | Population | Family Planning | Reproductive Behavior | Fertility | Population Dynamics | Program Evaluation | Programs | Organization and Administration Document Number: 330734 |
| 6. Title: Family planning saves lives. 4th ed. Author: Smith R; Ashford L; Gribble J; Clifton D Source: Washington, D.C., Population Reference Bureau [PRB], 2009. [2], 23 p. Abstract: To better address the cost implications of investing in mothers and children, the report provides useful data on the cost-benefits of family planning programs. Long considered a "best buy" among health investments, family planning is even more important in today's financially strapped environment. As countries grapple with recession and search for better ways to stretch limited budgets, family planning stands out as one of the most cost-effective, high-yield interventions available. At an average supply cost of US$1.55 per user annually, it offers a safe, affordable, and effective way for governments to reduce maternal and child illness and deaths, as well as reduce national health expenditures on reproductive and children's health problems. This latest edition also includes new information on how family planning reduces the rate of new HIV infections and deaths from AIDS as well as a "Special Focus" section on the challenges of repositioning family planning in sub-Saharan Africa, where programs have languished in many countries over the last decade. Language: English Keywords: DEVELOPING COUNTRIES | FAMILY PLANNING | CHILD SURVIVAL | INFANT MORTALITY | BIRTH INTERVALS | BREASTFEEDING | BIRTH SPACING | MATERNAL MORTALITY | REPRODUCTIVE HEALTH | ABORTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | HIV PREVENTION | AIDS PREVENTION | MATERNAL HEALTH | CHILD HEALTH | ADOLESCENTS | CONTRACEPTION | NEEDS | PROGRAM ACCESSIBILITY | ATTITUDES | Survivorship | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population | Fertility Measurements | Fertility | Infant Nutrition | Nutrition | Health | Fertility Control, Postconception | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | HIV Infections | Viral Diseases | AIDS | Youth | Age Factors | Population Characteristics | Economic Factors | Program Evaluation | Programs | Organization and Administration | Psychological Factors | Behavior Document Number: 325185 Notification |
| 7. Peer Reviewed Title: How contraceptive use affects birth intervals: results of a literature review. Author: Yeakey MP; Muntifering CJ; Ramachandran DV; Myint Y; Creanga AA Source: Studies in Family Planning. 2009 Sep;40(3):205-214. Abstract: Short birth intervals can have adverse consequences for maternal and infant outcomes. Optimal birth spacing is often presumed to be achieved through the practice of family planning and use of contraceptives, yet most of the available research does not address explicitly the contribution of contraceptive-method use to birth spacing or maternal and infant survival. We conducted a systematic literature review to assess the body of evidence linking contraceptive use to birth-interval length. Fourteen studies published in English between 1980 and 2008 met our eligibility criteria for inclusion. The findings from these studies are mixed but suggest that the use of contraceptives is protective against short birth intervals. Although results are favorable, many of the studies are methodologies employed are dated. More current research is needed to determine the impact of contraceptive-method use on birth-interval length in order to inform the promotion of family planning for reducing maternal and infant morbidity and mortality through birth spacing. Language: English Keywords: AFRICA | RESEARCH REPORT | LITERATURE REVIEW | BIRTH SPACING | CONTRACEPTION | CONTRACEPTIVE USAGE | INFANT MORTALITY | MATERNAL MORTALITY | PREVENTION AND CONTROL | Developing Countries | Family Planning | Mortality | Population Dynamics | Demographic Factors | Population | Diseases Document Number: 339702 |
8.  Title: Motivating healthy timing and spacing of pregnancies -- lessons from the field. Author: Johns Hopkins Bloomberg School of Public Health. Center for Communication Programs. Health Communication Partnership Source: Communication Impact!. 2008 Jan;(24):[2] p. Abstract: There is strong evidence that healthy timing and spacing of pregnancy saves lives from six key studies conducted between 2000 and 2005 (supported by USAID). These studies indicate the lack of appropriate spacing significantly harms maternal and child health. Birth-to-pregnancy intervals of less than six months were associated with a 150% increased risk of maternal mortality. Risk of induced abortion was 650% greater, and miscarriage 230% greater among women with short intervals. Child health was also adversely affected, including a 223% increased risk of newborn death. Studies conducted in 2007 in Jordan, Uganda, and Egypt by the Health Communication Partnership (HCP) illustrate how health communication approaches can help change community norms and promote birth spacing. (excerpt) Language: English Keywords: JORDAN | UGANDA | EGYPT | TECHNICAL REPORT | PREGNANCY INTERVALS | BIRTH SPACING | FAMILY SIZE | FAMILY PLANNING | COMMUNICATION STRATEGY | COMMUNICATION PROGRAMS | Developing Countries | Middle East | Africa, Eastern | Africa, Sub Saharan | Africa | Africa, North | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | Communication Document Number: 327607 |
| 9. Title: Healthy timing and spacing of pregnancy: a trainer's reference guide. Author: Pathfinder International. Extending Service Delivery Project Source: Washington, D.C., Pathfinder International, Extending Service Delivery Project, 2008 Aug. [144] p. (USAID Award No. GPO-A-00-05-00027-00) Abstract: The Extending Service Delivery (ESD) project has developed Healthy Timing and Spacing of Pregnancy: A Trainer's Reference Guide as a resource for trainers in developing in-service training for facility-based healthcare providers and community health workers (CHWs) who already have some basic experience with and understanding of RH/FP. This is not a training manual, but a reference guide which can be used and adapted by trainers based on whether or not trainees are are facility-based or community-based. HTSP training will enable providers to disseminate up-to-date and correct information and education on the health and social benefits of HTSP as part of RH/FP counseling and other health services. This information can help women better use FP to delay, space or limit their pregnancies, within a context of informed contraceptive choice. (excerpt) Language: English Keywords: GLOBAL | DEVELOPING COUNTRIES | TEACHING MATERIALS | BIRTH SPACING | BIRTH INTERVALS | TIME FACTORS | FAMILY PLANNING EDUCATION | INTERVENTIONS | CONTRACEPTIVE METHODS | TRAINING ACTIVITIES | TRAINING TECHNIQUES | MATERNAL HEALTH | MATERNAL HEALTH SERVICES | COUNSELING | Family Planning | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Education | Programs | Organization and Administration | Contraception | Training Programs | Health | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Clinic Activities | Program Activities Document Number: 328143 |
| 10. Title: Helping Egyptian women achieve optimal birth spacing intervals through fostering linkages between family planning and maternal / child health services. Author: Abdel-Tawab N; Loza S; Zaki A Source: [Washington, D.C.], Population Council, Frontiers in Reproductive Health, 2008 Sep. [45] p. (USAID Cooperative Agreement No. HRN-A-00-98-00012-00) Abstract: Population Council's USAID-funded Frontiers in Reproductive Health (FRONTIERS) program, in collaboration with the Egyptian Ministry of Health and Population (MOHP) and the NGO 'Social Planning, Analysis and Administration Consultants'; (SPAAC), conducted an operations research study to measure the acceptability and effectiveness of two birth spacing message models. For Model I (health services model), birth spacing messages were communicated through services by health workers to women during prenatal and postpartum periods. Model II (community awareness model), provided this service plus an awareness raising component that targeted men through training community influentials to communicate messages. Both models proved effective in changing women's knowledge and attitudes towards birth spacing and in enhancing use of contraception at 10-11 months postpartum, by 48 percent among Model I mothers and 43 percent among Model II mothers, compared with 31 percent among control group mothers. Over the postpartum period, women in the two intervention groups used contraception more consistently than women in the control group (median duration of protection against pregnancy was 6.8 months for Model I mothers, 4.5 months for Model II mothers and 2.9 months for control group mothers). Both intervention models were associated with an increased utilization of services, especially family planning services, by women who only had one child (36 percent increase in Model I clinics, 47 percent increase in Model II clinics and 3.2 percent in control clinics). However, a fear of contraceptive side-effects continues to be a major concern among women and men in all groups and is an obstacle in achieving healthy birth intervals. (Excerpts) Language: English Keywords: EGYPT | SUMMARY REPORT | OPERATIONS RESEARCH | WOMEN | BIRTH SPACING | FAMILY PLANNING | MATERNAL-CHILD HEALTH SERVICES | KNOWLEDGE | ATTITUDES | POSTPARTUM | CONTRACEPTIVE USAGE | UTILIZATION OF HEALTH CARE | PROGRAM ACCESSIBILITY | Developing Countries | Africa, North | Africa | Research Methodology | Program Evaluation | Programs | Organization and Administration | Demographic Factors | Population | Primary Health Care | Health Services | Delivery of Health Care | Health | Sociocultural Factors | Psychological Factors | Behavior | Puerperium | Reproduction | Contraception Document Number: 331442 |
| 11. Title: Birth spacing and maternal risk of invasive epithelial ovarian cancer in a Swedish nationwide cohort. Author: Baik I; Lambe M; Liu Q; Chie L; Cnattingius S; Mucci LA; Riman T; Ekbom A; Adami HO; Hsieh CC Source: Cancer Causes and Control. 2008 Dec;19(10):1131-7. Abstract: OBJECTIVE: Pregnancies reduce the risk of ovarian cancer, and among multiparous women, levels of circulating progesterone might be higher during pregnancies with wider birth spacing. We hypothesized that childbirth with wider birth spacing might reduce maternal risk of invasive epithelial ovarian cancer more than births with narrower spacing. METHODS: We conducted a case-control study nested in a nationwide cohort of Swedish women from 1961 to 2001. We selected five individually age-matched controls for each case of invasive epithelial ovarian cancer, and analysis for the effect of birth spacing was performed for 5,341 cases and 29,047 controls. We applied unconditional logistic regression analyses adjusting for age, ages at childbirth, educational level, area of residence, and gender of offspring. RESULTS: Relative risk of invasive epithelial ovarian cancer associated with each one-year increase in average birth spacing is 1.00 (95% CI = 0.98-1.01) among all women and 0.99 (0.98-1.01) among those born before 1935 and less likely to have used oral contraceptives. Further analyses on the biparous and triparous women did not find a consistent association between birth spacing and the risk of ovarian cancer. CONCLUSIONS: Birth spacing is unlikely to be a major determinant underlying the protective effects of childbirth on ovarian cancer risk. Language: English Keywords: SWEDEN | RESEARCH REPORT | CASE STUDIES | BIRTH SPACING | PROGESTERONE | OVARIAN CANCER | RISK FACTORS | Europe, Northern | Europe | Developed Countries | Studies | Research Methodology | Family Planning | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Cancer | Neoplasms | Diseases Document Number: 330103 |
| 12. Title: Birth-spacing, fertility and neonatal mortality in India: Dynamics, frailty, and fecundity. Author: Bhalotra S; van Soest A Source: Journal of Econometrics. 2008 Apr;143(2):274-290. Abstract: Using microdata on 30,000 childbirths in India and dynamic panel data models, we analyse causal effects of birth spacing on subsequent neonatal mortality and of mortality on subsequent birth intervals, controlling for unobserved heterogeneity. Right censoring is accounted for by jointly estimating a fertility equation, identified by using data on sterilization. We find evidence of frailty, fecundity, and causal effects in both directions. Birth intervals explain only a limited share of the correlation between neonatal mortality of successive children in a family. We predict that for every neonatal death, 0.37 additional children are born, of whom 0.30 survive. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | THEORETICAL MODELS | CORRELATION STUDIES | BIRTH SPACING | FERTILITY DETERMINANTS | NEONATAL MORTALITY | ESTIMATION TECHNIQUES | Developing Countries | Asia, Southern | Asia | Research Methodology | Statistical Studies | Studies | Family Planning | Fertility | Population Dynamics | Demographic Factors | Population | Infant Mortality | Mortality Document Number: 327065 |
| 13. Peer Reviewed Title: Your faith or mine: a pregnancy spacing intervention in an ultra-orthodox Jewish community in Israel. Author: Birenbaum-Carmeli D Source: Reproductive Health Matters. 2008 Nov;16(32):185-91. Abstract: Ultra-orthodox (haredi) Jews in Israel have an exceptionally high fertility rate of 7.7. As most fathers spend their days studying the Bible, the women struggle to support their large families under severe economic pressures. Some women experience maternal exhaustion coping with this life situation. Contraception for pregnancy spacing raises myriad dilemmas in the haredi community, however, many of which apply to promoting family planning in religious settings more generally. In a health promotion course for 23 haredi registered nurses at the University of Haifa in 2006-2007, pregnancy spacing was selected as the subject of the class project, the main aim of which was to convey an influential health message in a culturally acceptable manner. As the issue was debated, it was agreed the project should also address a range of women's health problems as well as pregnancy spacing. Thus, maternal nutrition, pelvic floor tone, dental health, maternal exhaustion and competition over number of children were added. A brochure was prepared and widely distributed in the haredi community, where it was well received. This paper describes the classroom dynamics during the planning and application of the project. It illustrates the importance of cultural awareness when addressing sensitive issues and communities with particular cultural dispositions. Language: English Keywords: ISRAEL | SUMMARY REPORT | STUDENTS | BIRTH SPACING | INTERVENTIONS | PROMOTION | JUDAISM | CULTURE | MATERNAL HEALTH | HEALTH EDUCATION MATERIALS | MESSAGE DEVELOPMENT | PAMPHLETS | Developed Countries | Middle East | Education | Family Planning | Programs | Organization and Administration | Marketing | Economic Factors | Religion | Sociocultural Factors | Health | Health Education | Communication | Printed Media | Mass Media Document Number: 342198 |
| 14. Title: Family planning needs during the extended postpartum period in Uttar Pradesh, India. Author: Borda M Source: [Baltimore, Maryland], JHPIEGO, ACCESS-FP, 2008. [4] p. (USAID Cooperative Agreement No. GHS-A-00-04-00002-00USAID Cooperative Agreement No. GPO-A-00-05-00025-00) Abstract: This analysis is based on the 2005-2006 National Family Health Survey III (NFHS III) data from Uttar Pradesh, India and summarizes key findings related to birth spacing and postpartum family planning. Inadequate birth spacing among the majority of women jeopardizes the health of mothers and the infants -- one of every three women in UP has less than a two-year gap between births. Three out of every four postpartum women in Uttar Pradesh expressed an unmet need for family planning. Unmet need decreases but remains high throughout the first year postpartum -- Almost 60% women still desired to space or limit subsequent births by the end of the year. Postpartum women are vulnerable --particularly three-six months after delivery: Exclusive breastfeeding drops, fertility returns and sexual activity resumes. Women who receive antenatal care (ANC) services are more likely to use postpartum family planning. Postpartum women need more contraceptive choices -- especially long-acting, highly-effective methodsfor limiting and highly-effective, reversible methods for spacing. Two of every three postpartum mothers in Uttar Pradesh were not using any family planning method. Women in Uttar Pradesh, India have a tremendous unmet need for family planning during the first year postpartum -- particularly the unmet need for limiting births. Women who use the formal medical system are more likely to have access and use family planning -- creating an opportunity to integrate FP messages with maternal and child health services. Programs need to reach women who are not in contact with the healthcare system during the antenatal and postpartum periods; Ensuring that postpartum women have access to quality postpartum services -- including family planning and counseling about birth spacing and limiting options -- is an important strategy in reducing both maternal and early childhood mortality. (Excerpts) Language: English Keywords: INDIA | SUMMARY REPORT | USAID | FAMILY PLANNING | NEEDS | POSTPARTUM | BIRTH SPACING | Asia, Southern | Asia | Developing Countries | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Economic Factors | Puerperium | Reproduction Document Number: 331444 |
| 15. Peer Reviewed Title: The associations between inter-pregnancy interval and maternal and neonatal outcomes in Brazil. Author: Cecatti JG; Correa-Silva EP; Milanez H; Morais SS; Souza JP Source: Maternal and Child Health Journal. 2008 Mar;12(2):275-281. Abstract: Global estimates of maternal and perinatal mortality have remained unchanged over the past 20 years, and strategies are being sought to decrease the occurrence of maternal and perinatal death. The objective of this study was to evaluate the association between inter-pregnancy interval and the occurrence of adverse maternal and perinatal outcomes. A cross-sectional study of the obstetrical and perinatal records in an intra-hospital obstetrics database between 1986 and 2000 at a tertiary maternity hospital in Brazil was examined. The participants totaled of 14,930 records of parous women who delivered singleton infants. The main outcome measures were crude and adjusted odds ratio estimates of gestational outcome according to inter-pregnancy intervals. During the period of the study, 34.6% of records referred to women with an inter-pregnancy interval less than 18 months. After the adjustment performed for 11 confounding factors and assuming an inter-pregnancy interval of 18-23 months as reference, short intervals (less than 6 months) were observed to be associated with a greater risk of low birth weight (odds ratio: 1.74; 95% confidence interval: 1.18-2.55), and preterm birth (1.56; 1.01-2.46). On the other hand, long intervals were significantly associated with fewer C-sections (0.69; 0.56-0.82), and a greater risk of premature rupture of membranes (PROM) (1.57; 1.20-2.06) and low birth weight (1.46; 1.03-2.06). Short inter-pregnancy intervals are associated with a higher risk of low birth weight and preterm birth, while long intervals are associated with a higher risk of PROM, low birth weight and a lower risk of C-section. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PREGNANCY INTERVALS | BIRTH SPACING | RISK ASSESSMENT | LOW BIRTH WEIGHT | PREMATURE BIRTH | CESAREAN SECTION | MATERNAL HEALTH | INFANT HEALTH | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Family Planning | Evaluation | Birth Weight | Body Weight | Physiology | Biology | Pregnancy Outcomes | Pregnancy | Reproduction | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Child Health Document Number: 324359 |
| 16. Peer Reviewed Title: Towards smaller family size in Egypt, Morocco and Turkey: Overall change over time or socio-economic compositional effect? Author: D'Addato AV; Vignoli D; Yavuz S Source: Population Review. 2008;47(1):[14] p. Abstract: The whole region of the South and East Mediterranean exhibits a profound fertility transition with marked differences in the pace of fertility declines among the countries. The authors choose three representative countries: Egypt, Morocco and Turkey. Determinants of the propensity towards smaller family size are investigated as scrutinizing the development in the pattern of third births, which represents the critical step in the transitional process for these countries. The authors are particularly interested in verifying whether the decline of higher-order births is significantly driven by an overall societal change over time or by compositional change over different socio-economic segments of the female population. Evidence is found that overall societal changes have mainly driven the decline in large family size, though, to a much lesser extent, compositional changes are important too. (author's) Language: English Keywords: EGYPT | MOROCCO | TURKEY | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | RETROSPECTIVE STUDIES | FERTILITY CHANGES | FAMILY SIZE | SOCIAL CHANGE | BIRTH LIMITING | BIRTH SPACING | Developing Countries | Africa, North | Africa | Europe, Southeastern | Europe | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Studies | Research Methodology | Fertility | Family Characteristics | Family and Household | Sociocultural Factors | Family Planning Document Number: 327572 |
| 17. Peer Reviewed Title: The effects of pregnancy spacing on infant and child mortality in Matlab, Bangladesh: How they vary by the type of pregnancy outcome that began the interval. Author: DaVanzo J; Hale L; Razzaque A; Rahman M Source: Population Studies. 2008;62(2):131-154. Abstract: Using high-quality longitudinal data on 125,720 singleton live births in Matlab, Bangladesh, we assessed the effects of duration of intervals between pregnancy outcomes on infant and child mortality and how these effects vary over subperiods of infancy and childhood and by the type of outcome that began the interval. Controlling for other correlates of infant and child mortality, we find that shorter intervals are associated with higher mortality. Interval effects are greater if the interval began with a live birth than with another pregnancy outcome. In the first week of the child's life, the effects of short intervals are greater if the sibling born at the beginning of the interval died; after the first month, the effects are greater if that sibling was still alive. Many relationships found are consistent with the maternal depletion hypothesis, and some with sibling competition. Some appear to be due to correlated risks among births to the same mother. (author's) Language: English Keywords: BANGLADESH | RESEARCH REPORT | QUANTITATIVE RESEARCH | LONGITUDINAL STUDIES | INFANT MORTALITY | CHILD MORTALITY | PREGNANCY OUTCOMES | BIRTH SPACING | BIRTH INTERVALS | Developing Countries | Asia, Southern | Asia | Research Methodology | Studies | Mortality | Population Dynamics | Demographic Factors | Population | Pregnancy | Reproduction | Family Planning | Fertility Measurements | Fertility Document Number: 327525 |
| 18. Peer Reviewed Title: Rapid fertility decline in Iran: Analysis of intermediate variables. Author: Erfani A; McQuillan K Source: Journal of Biosocial Science. 2008 May;40(3):459-478. Abstract: The remarkable decline in fertility in Iran, which saw the total fertility rate fall from 7 children per woman in 1986 to 2 in 2000, has received only limited analysis in the demographic literature. Using the 2000 Iran Demographic and Health Survey and Bongaarts' age-specific fertility model, this paper examines the role of the major proximate determinants of fertility in bringing about the rapid decrease in fertility in Iran. The analysis indicates that contraception had the largest effect on fertility, accounting for 61% of the reduction in fertility from its theoretical maximum. The fertility-inhibiting effect of marriage patterns accounted for an additional 31% reduction, and was most important among the young. Further analysis of contraceptive behaviour suggests that the current period fertility rate of 2-0 children per woman is an outcome of a synchronization of delaying and spacing of births among younger women with stopping of childbearing among women in the middle and late reproductive ages. The policy implications of the results are discussed. (author's) Language: English Keywords: IRAN | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | THEORETICAL MODELS | AGE SPECIFIC FERTILITY RATE | FERTILITY DECLINE | FERTILITY DETERMINANTS | CONTRACEPTIVE USAGE | MARRIAGE PATTERNS | BIRTH SPACING | Developing Countries | Middle East | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Research Methodology | Fertility Rate | Birth Rate | Fertility Measurements | Fertility | Fertility Changes | Contraception | Family Planning | Marriage | Nuptiality Document Number: 325414 |
| 19. Title: Determinants of family size in a Gulf Arab state: a comparison between two areas. Author: Hamadeh RR; Al-Roomi K; Masuadi E Source: Journal of the Royal Society of Health. 2008 Sep;128(5):226-32. Abstract: AIMS: The rapid economic transition in the Gulf Arab countries has resulted in marked changes in fertility and marriage patterns and a decrease in the number of children per family. Yet little is known about the determinants of family size in urban and less urban areas. METHODS: A cross-sectional study was carried out on 450 Kuwaiti women aged 20-60 years who attended health care centres in Al Asima and Al Jahra governorates. A semi-structured questionnaire was administered through face-to-face interview which included variables on socio-demographic characteristics, family size, actual and ideal spacing, marriage related variables, health conditions and utilization of health services. Both univariate and multivariate analyses were performed to identify the factors that affect family size. RESULTS: The socio-economic indicators were significantly better in Al Asima, the capital, than in Al Jahra, a less urbanized area. On average, family size for the total sample was 5.97 +/- 0.114 with a larger size (6.27 +/- 0.242) in Al Jahra than in Al Asima (5.80 +/- 0.118) but without a significant difference. Al Jahra women reported a larger number of deliveries and past pregnancies but a lower usage of contraceptive measures. The total fertility rate was 3.65 in Al Asima, 3.84 in Al Jahra and 3.71 births per woman in the total population. Family size was inversely related to the educational level of women and their husbands. Currently employed women had a smaller family size (5.22 +/- 0.119) than the unemployed (6.81 +/- 0.187); p < 0.0005. Health problems in the interviewee or her husband played a minor role in the decision to have more children. Families where the husband was the decision-maker on the number of children had a significantly larger family size (6.91 +/- 0.451) than families where the couple both participated in the decision (5.83 +/- 0.129; p = 0.032). The duration of marriage, ideal number of children, age of women at last delivery, number of rooms and the crowding index had significant positive effects on family size, whereas age at first delivery, duration between two consecutive pregnancies and history of past abortions were inversely related to family size in the stepwise multiple regression analysis. CONCLUSIONS: Although women in the less urbanized areas in the Gulf Arab populations are more disadvantaged with respect to socio-economic characteristics than women in the more urbanized areas, there were no significant differences in family size in these contrasting communities. The impact of socio-demographic characteristics on family size was minor compared to factors related to fertility and the husband's desire to have more children. Fertility and family planning policies should consider these issues in order to promote more effective programmes. Language: English Keywords: KUWAIT | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | INTERVIEWS | WOMEN | RESPONDENTS | FAMILY SIZE | BIRTH SPACING | MARRIAGE PATTERNS | WOMEN'S HEALTH | HEALTH SERVICES | UTILIZATION OF HEALTH CARE | SOCIOECONOMIC FACTORS | FERTILITY CHANGES | Middle East | Developed Countries | Research Methodology | Data Collection | Demographic Factors | Population | Surveys | Sampling Studies | Studies | Family Characteristics | Family and Household | Sociocultural Factors | Family Planning | Marriage | Nuptiality | Health | Delivery of Health Care | Economic Factors | Fertility | Population Dynamics Document Number: 328680 |
| 20. Title: Unintended pregnancies remain high in Jordan. Author: Jurdi R Source: Washington, D.C., Population Reference Bureau [PRB], 2008 Sep. 5 p. (MENA Working Paper Series) Abstract: Every pregnancy should be intended and wanted, according to the Jordanian government's policies and international agreements related to family planning and reproductive health. However, one in three pregnancies in Jordan is unintended--either mistimed or unwanted. Policies and programs that reduce unintended pregnancies are justified on health and human rights grounds, and they can help Jordan achieve its population and development goals. This research paper intends to help policymakers and program managers in Jordan understand the extent and nature of unintended pregnancies and their implications for women and their families. A better understanding of unintended pregnancies and their causes will enable decisionmakers to remove obstacles that prevent families from having their desired number of children. Language: English Keywords: JORDAN | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | RECOMMENDATIONS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | PREGNANCY, UNPLANNED | PREGNANCY, UNWANTED | POPULATION POLICY | FAMILY PLANNING POLICY | FERTILITY DECLINE | BIRTH SPACING | PREGNANCY RATE | Developing Countries | Middle East | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Economic Development | Economic Factors | Population Characteristics | Reproductive Behavior | Fertility | Social Policy | Policy | Political Factors | Sociocultural Factors | Family Planning | Fertility Changes | Fertility Measurements Document Number: 323151 |
| 21. Title: Unmet need and the demand for family planning in Uganda. Further analysis of the Uganda Demographic and Health Surveys, 1995-2006. Author: Khan S; Bradley SE; Fishel J; Mishra V Source: Calverton, Maryland, Macro International, MEASURE DHS, 2008 Aug. 42 p. (USAID Contract No. GPO-C-00-03-00002-00DHS Further Analysis No. 60) Abstract: Uganda is the third fastest growing country in the world. Contraceptive use is low, and the unmet need for family planning is high. This study examines unmet need in Uganda from 1995 to 2006 using data from three consecutive rounds of the Demographic and Heath Surveys. The study provides levels, trends, and differentials for unmet need; the factors associated with unmet need; reasons for contraceptive nonuse; and the likely impact of reducing unmet need. The results show that unmet need is highest among currently married women, women in rural areas, and women in the Northern region. Unmet need is increasing among the all-women group, currently married women, all sexually active women, and never-married sexually active women. Unmet need remains steady at low levels among never-married women and formerly married women. Unmet need for spacing is more prevalent than for limiting. Women with an unmet need for spacing and limiting both tend to have more than two living children. Women with an unmet need for spacing are more likely to lack employment, live in the Northern region, and not receive family planning messages in the media while women with an unmet need for limiting, in contrast, tend to be older and live in rural areas. Total unmet need is associated with higher parity (2 or more children) and living in the Northern region. Substantial proportions of women do not use, and do not intend to use, contraception in the future due to the fear of side effects and opposition from the husband or partner. Based on statistical models, modest declines in unmet need and increases in contraceptive prevalence in Uganda can substantially reduce the country's total fertility rate. Language: English Keywords: UGANDA | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | WOMEN IN DEVELOPMENT | COUPLES | RURAL POPULATION | FAMILY PLANNING | CONTRACEPTIVE PREVALENCE | MARITAL STATUS | HUMAN GEOGRAPHY | BIRTH SPACING | MASS MEDIA | UNEMPLOYMENT | AGE FACTORS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Economic Development | Economic Factors | Family Characteristics | Family and Household | Sociocultural Factors | Population Characteristics | Contraceptive Usage | Contraception | Nuptiality | Geography | Social Sciences | Science | Communication | Employment | Macroeconomic Factors Document Number: 329539 |
| 22. Title: A literature search on birth spacing and maternal depletion. Author: Kong S; Wahl A Source: Washington, D.C., United States Agency for International Development [USAID], Knowledge Services Center, 2008 Apr 22. 10 p. (KSC Research SeriesPN-ADM-021USAID Contract No. RAN-M-00-07-00003-00) Abstract: This document compiles the results of a literature search on birth spacing and maternal depletion using various databases, including Medline, Popline, and Lilacs. Language: English Keywords: GLOBAL | SUMMARY REPORT | LITERATURE REVIEW | USAID | PREVALENCE | PREGNANT WOMEN | BIRTH SPACING | ANEMIA | MATERNAL NUTRITION | DEFICIENCY DISEASES | SERUM IRON LEVEL | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Measurement | Research Methodology | Population Characteristics | Demographic Factors | Population | Family Planning | Diseases | Nutrition | Health | Nutrition Disorders | Hemic System | Physiology | Biology Document Number: 331589 |
| 23. Title: Birth spacing, fertility selection and child survival: Analysis using a correlated hazard model. Author: Maitra P; Pal S Source: Journal of Health Economics. 2008 May;27(3):690-705. Abstract: If fertility reflects the choice of households, results of their choice (duration between successive births and health of the children) cannot be considered to be determined randomly. Most existing studies of child health, however, tend to overlook the effects of fertility selection on child health. This paper argues that not accounting for this selection issue yields biased estimates and it is difficult a priori to predict the direction of this bias. We find that the estimates of birth spacing on child mortality are different when we do not account for fertility selection. Additionally, the correlated hazard estimates that we present here better fit our samples than the corresponding bivariate probit estimates used in the literature. A comparison of the fertility behaviour of households in the Indian and the Pakistani Punjab highlights the differential nature of institutions on demographic transition in these neighbouring regions. (author's) Language: English Keywords: INDIA | PAKISTAN | RESEARCH REPORT | HEALTH SURVEYS | REPRODUCTIVE BEHAVIOR | CHILD MORTALITY | BIRTH SPACING | BIAS | ESTIMATION TECHNIQUES | Developing Countries | Asia, Southern | Asia | Health | Fertility | Population Dynamics | Demographic Factors | Population | Mortality | Family Planning | Error Sources | Measurement | Research Methodology Document Number: 326879 |
| 24. Title: Understanding the effects of siblings on child mortality: Evidence from India. Author: Makepeace G; Pal S Source: Journal of Population Economics. 2008 Oct;21(4):877-902. Abstract: Given the intrinsically sequential nature of childbirth, timing of a child's birth has consequences not only for itself but also for its older and younger siblings. The paper argues that prior spacing and posterior spacing between consecutive siblings are thus important measures of intensity of sibling competition for limited parental resources. While the available estimates of child mortality tend to ignore the endogeneity of sibling composition, we use a correlated recursive model of prior and posterior spacing and child mortality to correct it. There is evidence that uncorrected estimates under-estimate the effects of prior and posterior spacing on child mortality. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | HEALTH SURVEYS | THEORETICAL MODELS | CORRELATION STUDIES | CHILD MORTALITY | BIRTH SPACING | BIRTH INTERVALS | TIME FACTORS | SIBLINGS | SEX PREFERENCE | Developing Countries | Asia, Southern | Asia | Health | Research Methodology | Statistical Studies | Studies | Mortality | Population Dynamics | Demographic Factors | Population | Family Planning | Fertility Measurements | Fertility | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Value Orientation | Psychological Factors | Behavior Document Number: 327940 |
| 25. Title: Implanon sub-dermal implants: a 10-month review of acceptability in Jos, North-Central Nigeria. Author: Mutihir JT; Daru PH Source: Nigerian Journal of Clinical Practice. 2008 Dec;11(4):320-3. Abstract: OBJECTIVE: To determine the acceptance of Implanon so far, the group of women accepting it, insertion complications and immediate post insertion problems, if any, and report our initial experience with the method. METHODOLOGY: This was a retrospective review study of all cases of Implanon acceptors between 1st May and 28th February 2007. Demographic and social factors were collated. Insertion and post-insertion complications were evaluated. RESULTS: A total of 2,608 clients accepted contraceptive methods out of which 350 clients had Implanon capsules inserted within the study period (13.4%). One hundred and ninety-one (54.6%) of the acceptors desired more children, and therefore using it to space pregnancies, 154 (44.0%) would not want more children, but opted for the temporary long term method, and 5 (1.4%) were uncertain whether to have more children in the future or not. The mean age and parity of acceptors were 32.4 years and 3.6 respectively. The mean number of living children to the women was 3.4. All the women were married. About three-quarters (75.8%) of the women had secondary and tertiary education. Seventy-two (20.6%) of the women were taking a modern contraceptive method for the first time. The rest 278 (79.4%) had used one or more methods of contraception, and were only switching over to Implanon sub-dermal implants. The patients weighed between 40 and 122 kg with an average of 62.4 kg. Post-insertion complications like infection, expulsion, bruising and induration were not reported. Four women discontinued the method for varying reasons. CONCLUSION: Women are accepting the new method. Over three-quarters of the clients are switching from other methods to Implanon. The method appears to have good continuation rate and therefore a promising long term sub-dermal contraceptive method amongst our women. Language: English Keywords: NIGERIA | RESEARCH REPORT | KAP SURVEYS | RETROSPECTIVE STUDIES | WOMEN IN DEVELOPMENT | CONTRACEPTIVE IMPLANTS | COMPLICATIONS | DEMOGRAPHIC FACTORS | BIRTH SPACING | FAMILY SIZE, DESIRED | EDUCATIONAL STATUS | CONTRACEPTIVE METHOD SWITCHING | CONTRACEPTION TERMINATION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Contraceptive Methods | Contraception | Family Planning | Diseases | Population | Family Size | Family Characteristics | Family and Household | Sociocultural Factors | Socioeconomic Status | Socioeconomic Factors | Contraceptive Usage Document Number: 331255 |
| 26. Title: Studies on the predisposing factors of iron deficiency anaemia among pregnant women in a Nigerian community. Author: Okwu GN; Ukoha AI Source: Pakistan Journal of Nutrition. 2008 Jan-Feb;7(1):151-156. Abstract: Iron Deficiency Anaemia (IDA) is a major public health problem in developing countries especially among pregnant women. This study was done on some of the factors that predispose pregnant women to IDA and so identify groups at greater risk. A total of 1387 pregnant women (910 in the urban area and 477 in the rural areas) were recruited for the study. IDA was assessed by measuring haemoglobin (Hb) concentration and the pregnant women were considered anaemic for Hb less than 11g/dl according to World Health Organization Standards. Semi structured questionnaires were used to elicit information on possible predisposing factors such as age, level of education, parity, child-spacing etc. Results obtained showed that mean Hb of the rural subjects, 9.84 plus or minus 1.41g/dl was significantly (p less than 0.0001) lower than that of the urban subjects, 10.44 plus or minus 1.49g/dl. Analysis of the effect of age showed that the younger age category (24 years and below) had significantly (p less than 0.0461) lower mean Hb and significantly (p less than 0.0332) higher percentage of anaemia while the effect of level of education showed significantly (p less than 0.0136) lower mean Hb and higher proportion of anaemia among the less educated (no formal and primary education). The pregnant women with child spacing of less than 1 year and 1-1.5 years had significantly (p less than 0.0223) lower mean Hb and significantly (p less than 0.0336) higher prevalence of anaemia while parity did not show any significant effect on both mean Hb and prevalence of Hb. The implications of these findings are discussed and recommendations made on how to tackle the problem. (author's) Language: English Keywords: NIGERIA | RESEARCH REPORT | QUESTIONNAIRES | PREGNANT WOMEN | ANEMIA | DEFICIENCY DISEASES | IRON | AGE FACTORS | EDUCATIONAL STATUS | PARITY | BIRTH SPACING | RECOMMENDATIONS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Population Characteristics | Demographic Factors | Population | Diseases | Nutrition Disorders | Metals | Vitamins and Minerals | Physiology | Biology | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Fertility Measurements | Fertility | Population Dynamics | Family Planning Document Number: 323633 |
| 27. Title: Family planning implementation teams: building sustainable community ownership in rural Uganda. Author: Patterson J Source: Washington, D.C., Core Group, [2008]. 8 p. Abstract: Minnesota International Health Volunteers (MIHV) is improving family planning knowledge, access, and use in Ssembabule and Mubende, two rural districts of central Uganda. MIHV's Uganda Child Spacing Program (UCSP, 2006-2009) is funded by the U.S. Agency for International Development and supported by the Uganda Ministry of Health. The UCSP uses a community-based strategy to increase demand for family planning services and to increase supply of family planning methods to women and men who choose to use them. A critical component to this strategy is the Family Planning Implementation Team (FPIT), established in both districts to facilitate and coordinate MIHV's community-based work. The purpose of this case study is to describe how the Family Planning Implementation Teams have contributed to the successful implementation of the UCSP. The document also briefly highlights the FPIT members and how they work together, as well as the challenges of using FPITs. It closes with a handful of lessons that MIHV has learned which may be useful to other groups that are implementing community based family planning programs. Language: English Keywords: UGANDA | PROGRESS REPORT | KAP SURVEYS | RURAL POPULATION | FAMILY PLANNING PERSONNEL | FAMILY PLANNING PROGRAM EVALUATION | BIRTH SPACING | COMMUNITY HEALTH SERVICES | CONTRACEPTIVE DISTRIBUTION | COMMUNITY-BASED DISTRIBUTION | COMMUNITY PARTICIPATION | LEADERSHIP | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Family Planning Programs | Family Planning | Primary Health Care | Health Services | Delivery of Health Care | Health | Distributional Activities | Program Activities | Programs | Organization and Administration | Nonclinical Distribution Document Number: 308947 |
| 28. Title: Back to basics: the rationale for increased funds for international family planning. Author: Sarot S Source: Guttmacher Policy Review. 2008 Summer;11(3):13-18. Abstract: Contributions from the U.S. government to voluntary family planning activities in developing countries have generated considerable successes over the last four decades. Yet, the U.S. family planning and reproductive health program, administered primarily through the U.S. Agency for International Development (USAID), has encountered and continues to face many roadblocks to further progress, including policy impediments to sound programming imposed by the government itself. Such self-imposed setbacks include the "Mexico City" policy, also known as the global gag rule, which renders local organizations that engage in privately funded abortion-related activities consistent with their own country's laws ineligible for U.S. support for contraceptive services. Additional policy constraints involve withdrawal of U.S. assistance to the United Nations Population Fund (UNFPA) on the grounds that UNFPA's support of voluntary contraceptive services in China is somehow tantamount to support of coercive abortion. While these policy problems have caused serious injury and will require repair, an equally important challenge for policymakers under a new presidential administration will be to remedy the trend of chronic underfunding of international family planning programs. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | UNITED STATES OF AMERICA | CRITIQUE | EVALUATION | WOMEN IN DEVELOPMENT | POLICYMAKERS | FAMILY PLANNING POLICY | FOREIGN AID | DEVELOPMENT POLICY | NEEDS ASSESSMENT | CONTRACEPTIVE AVAILABILITY | BIRTH SPACING | MATERNAL HEALTH | CHILD SURVIVAL | WOMEN'S STATUS | Developed Countries | North America | Americas | Economic Development | Economic Factors | Administrative Personnel | Organization and Administration | Family Planning | Population Policy | Social Policy | Policy | Political Factors | Sociocultural Factors | Financial Activities | Contraception | Health | Survivorship | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population | Socioeconomic Factors Document Number: 323169 |
| 29. Peer Reviewed Title: On postponement and birth intervals. Author: Timaeus IM; Moultrie TA Source: Population and Development Review. 2008 Sep;34(3):483-510. Abstract: Much of the literature on fertility transition presumes that birth control is practiced either to limit family size or to space births. This article argues that women also use birth control to postpone pregnancy. Postponement is not synonymous with spacing. It arises when women delay their next birth for indefinite periods for reasons unrelated to the age of their youngest child, but without deciding not to have any more children. Postponement has a distinctive impact on the shape of birth-interval distributions that differs from the impacts of family size limitation, birth spacing, or a mixture of the two behaviors. Some populations, such as that in South Africa, have developed fertility regimes characterized by birth intervals far longer than can be accounted for by birth spacing. Postponement of further childbearing that eventually becomes permanent may be an important driver of the transition to lower fertility in sub-Saharan Africa. (author's) Language: English Keywords: GLOBAL | AFRICA, SUB SAHARAN | RESEARCH REPORT | CONTRACEPTIVE USAGE | CONTRACEPTIVE USAGE DETERMINANTS | DELAYED CHILDBEARING | FERTILITY DECLINE | FERTILITY DETERMINANTS | FERTILITY PREFERENCES | BIRTH INTERVALS | BIRTH SPACING | DEMOGRAPHIC TRANSITION | Africa | Developing Countries | Contraception | Family Planning | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Fertility Changes | Fertility Measurements Document Number: 328098 |
| 30. Peer Reviewed Title: Cross-sectional analysis of factors associated with prior contraceptive use among hospitalized obstetric patients in Kabul, Afghanistan. Author: Todd CS; Isley MM; Ahmadzai M; Azfar P; Atiqzai F Source: Contraception. 2008 Sep;78(3):249-256. Abstract: This study was conducted to assess prevalence and correlates of prior contraceptive use among hospitalized obstetric patients in Kabul, Afghanistan. Study Design: Medically eligible (e.g., conditions not requiring urgent medical attention, such as eclampsia, or not imminently delivering [dilation >or=8 cm]) obstetric patients admitted to three Kabul public hospitals were consecutively enrolled in this cross-sectional study. An interviewer-administered questionnaire assessed demographic information, health utilization history, including prior contraceptive use, and intent to use contraception. Correlates of prior contraceptive use were determined with logistic regression. Results: Of 4452 participants, the mean age was 25.7 years (SD, +or-5.7 years), 66.4% reported pregnancy before the presenting gestation, 88.4% had >or=1 prenatal care visit and 82.4% reported the current pregnancy was desired. Most (67.4%) had no formal education. One fifth (22.8%) reported using contraception before this pregnancy. Among women with any pregnancy before the current gestation (98.6% of prior users), prior contraceptive use was independently associated with having lived outside Afghanistan in the last 5 years (adjusted odds ratio [AOR], 1.35; 95% confidence interval [CI], 1.12-1.63), having a skilled attendant at the last birth (AOR, 1.35; 95% CI, 1.07-1.71), having a greater number of living children (AOR, 1.30; 95% CI, 1.20-1.41), longer mean birth interval (years) (AOR, 1.21; 95% CI, 1.11-1.38) and higher educational level (AOR, 1.16; 95% CI, 1.09-1.22). Immediate desire for another pregnancy and spousal disapproval were the most common reasons for not utilizing contraception. Conclusion: Prior contraceptive use is low among the women in Kabul, Afghanistan, particularly for younger less educated women. Programming in Kabul to strengthen postpartum contraceptive counseling should address barriers to contraceptive use, including immediate desire for pregnancy and spousal attitudes. (author's) Language: English Keywords: AFGHANISTAN | CROSS SECTIONAL ANALYSIS | CONTRACEPTIVE USAGE | CONTRACEPTIVE PREVALENCE | BIRTH SPACING | EDUCATIONAL STATUS | Asia, Southern | Asia | Developing Countries | Research Methodology | Contraception | Family Planning | Socioeconomic Status | Socioeconomic Factors | Economic Factors Document Number: 327829 |
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