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Training Service Providers On Emergency Contraception: Lessons Learned From An Or Study, M.E. Khan, Sharif M.I. Hossain
Training Service Providers On Emergency Contraception: Lessons Learned From An Or Study, M.E. Khan, Sharif M.I. Hossain
Reproductive Health
The Bangladesh Directorate of Family Planning in collaboration with the Population Council, Pathfinder International, and John Snow, Inc. is conducting an operations research project to test the feasibility of introducing emergency contraceptive pills (ECP) in the national family planning (FP) program and to answer operational questions on implementing the use of ECP efficiently. In Bangladesh, 1.2 million births are unplanned and the number of menstrual regulation/abortions is increasing. ECP could be a good reproductive health intervention for women since it gives them a chance to avoid unwanted pregnancy. ECP does not induce abortion. In fact, it helps in reducing the …
Best Practices In Cbd Programs In Sub-Saharan Africa: Lessons Learned From Research And Evaluation, Frontiers In Reproductive Health, Family Health International, Advance Africa
Best Practices In Cbd Programs In Sub-Saharan Africa: Lessons Learned From Research And Evaluation, Frontiers In Reproductive Health, Family Health International, Advance Africa
Reproductive Health
Community-based distribution (CBD) is the use of nonprofessional local distributors or agents to provide family planning (FP) methods—typically condoms, pills, and spermicides—and referral for other services. FP programs in Africa, Asia, and Latin America have implemented CBD programs for the past 30 years. There is a large body of evidence on the effectiveness, cost, and sustainability of CBD models. Most evidence supports using CBD where appropriate conditions exist. However, major changes have taken place in the context in which programs operate, including the onset of the HIV/AIDS pandemic, enhanced access to FP services, and increased demand for related reproductive health …
Men In Maternity Study: A Summary Of The Findings From Pre-Intervention Interviews With Women And Their Husbands Attending Antenatal Clinics At Esic Facilities In Delhi, Anurag Mishra, Leila Caleb-Varkey, Anjana Das, Emma Ottolenghi, Dale Huntington, Susan E. Adamchak, Shahina Begum
Men In Maternity Study: A Summary Of The Findings From Pre-Intervention Interviews With Women And Their Husbands Attending Antenatal Clinics At Esic Facilities In Delhi, Anurag Mishra, Leila Caleb-Varkey, Anjana Das, Emma Ottolenghi, Dale Huntington, Susan E. Adamchak, Shahina Begum
Reproductive Health
The Frontiers in Reproductive Health program, a USAID-funded project of the Population Council is conducting an operations research (OR) study that investigates the effects of male participation in a new model of maternity care that is gender sensitive and provided at the primary-care level. The immediate objectives are to increase the use of family planning methods in the postpartum period and to promote STI primary preventive practices in men and women. The three-year study called Men in Maternity (MiM) is being conducted in South Africa and India. In India, the project is collaborating with the Employees State Insurance Corporation (ESIC). …
Baseline Survey Results: Integrating Adolescent Livelihood Activities Within A Reproductive Health Program For Urban Slum Dwellers In India, Mary Philip Sebastian, Dale Huntington, Wesley H. Clark, Barbara Mensch, Bela Patel Uttekar
Baseline Survey Results: Integrating Adolescent Livelihood Activities Within A Reproductive Health Program For Urban Slum Dwellers In India, Mary Philip Sebastian, Dale Huntington, Wesley H. Clark, Barbara Mensch, Bela Patel Uttekar
Reproductive Health
The Population Council’s Frontiers in Reproductive Health Program and Policy Research Division, in collaboration with CARE India, is conducting an operations research study of an intervention designed to improve the lives and prospects of young women in several urban slum areas of Allahabad, Uttar Pradesh. The project aims to take a preexisting reproductive health program for adolescents and test the feasibility and impact of adding four additional components to it: 1) counseling about savings formation and livelihoods, 2) training in vocational skills, 3) assistance in opening savings accounts, and 4) follow-up support. CARE India is managing the larger adolescent reproductive …
Men In Maternity Study: Results From The Pre-Intervention Survey Of Pregnant Women And Their Husbands At The Three Interventions, And Of Only Women At Three Control Employees' State Insurance Corporation Dispensaries In Delhi, India: Preliminary Findings, Anurag Mishra, Leila Caleb-Varkey, Emma Ottolenghi, Anjana Das, Dale Huntington, Susan E. Adamchak
Men In Maternity Study: Results From The Pre-Intervention Survey Of Pregnant Women And Their Husbands At The Three Interventions, And Of Only Women At Three Control Employees' State Insurance Corporation Dispensaries In Delhi, India: Preliminary Findings, Anurag Mishra, Leila Caleb-Varkey, Emma Ottolenghi, Anjana Das, Dale Huntington, Susan E. Adamchak
Reproductive Health
The Frontiers in Reproductive Health program, a USAID-funded project of the Population Council, is conducting an operations research (OR) study that investigates the effects of male participation in a new model of maternity care that is gender sensitive and provided at the primary-care level. The immediate objectives are to increase the use of family planning methods in the postpartum period and to promote STI primary preventive practices in men and women. The three-year study called Men in Maternity (MiM) is being conducted in South Africa and India. In India, the project is collaborating with the Employees State Insurance Corporation (ESIC). …
Anti-Trafficking Programs In South Asia: Appropriate Activities, Indicators And Evaluation Methodologies, Dale Huntington
Anti-Trafficking Programs In South Asia: Appropriate Activities, Indicators And Evaluation Methodologies, Dale Huntington
Reproductive Health
Throughout South Asia, men, women, boys, and girls are trafficked within their own countries and across international borders against their wills in what is essentially a clandestine slave trade. The Congressional Research Service and the U.S. State Department estimate that between 1 to 2 million people are trafficked each year worldwide with the majority originating in Asia. Root causes include extreme disparities of wealth, increased awareness of job opportunities far from home, pervasive inequality due to caste, class, and gender bias, lack of transparency in regulations governing labor migration, poor enforcement of internationally agreed-upon human rights standards, and the enormous …
Philippines And Senegal: Services Improve Quality Of Care But Fail To Increase Fp Continuation, Frontiers In Reproductive Health
Philippines And Senegal: Services Improve Quality Of Care But Fail To Increase Fp Continuation, Frontiers In Reproductive Health
Reproductive Health
In 1999, Frontiers in Reproductive Health collaborated on studies on the impact of interventions to improve quality of care in the Philippines and Senegal. The two interventions were part of a multicountry Population Council study (also undertaken in Pakistan and Zambia) to test whether improving quality affects women’s contraceptive continuation. The Philippines study focused on training in family planning (FP), supportive supervision, and refresher courses to improve client-provider interaction. The Senegal study compared the impact of improved quality of care at five newly established “reference centers” with five clinics that served as controls. Data were gathered through analyses of quality …
Social Organization And Reproductive Behavior In Southern Ghana, Dominic K. Agyeman, John B. Casterline
Social Organization And Reproductive Behavior In Southern Ghana, Dominic K. Agyeman, John B. Casterline
Poverty, Gender, and Youth
The objective of this research is to examine the association between social organization and reproductive behavior in one setting in sub-Saharan Africa. The particular focus is on the effects of social organization on the diffusion of innovative reproductive ideas and behaviors. Social diffusion is assumed to be strongly affected by patterns of informal social interaction, and these in turn are assumed to be determined in part by the social organization of local communities (gender relations, employment activity, voluntary organizations). The research draws on data collected in six communities in southern Ghana. The analysis reveals a weaker than expected association between …
Using Operations Research To Strengthen Programmes For Encouraging Abandonment Of Female Genital Cutting. Report Of A Consultative Meeting On Methodological Issues For Fgc Research, Frontiers In Reproductive Health
Using Operations Research To Strengthen Programmes For Encouraging Abandonment Of Female Genital Cutting. Report Of A Consultative Meeting On Methodological Issues For Fgc Research, Frontiers In Reproductive Health
Reproductive Health
The Population Council’s Frontiers in Reproductive Health program, with funding from USAID, organized a consultative meeting on the practice of female genital cutting (FGC) in Nairobi, Kenya in April 2002. The meeting brought together a small group of researchers and program managers who are actively undertaking operations research and systematic program evaluations to review the state of the art concerning intervention research design and measurement issues. The deliberations at this workshop should stimulate interest both in undertaking operations research more routinely when programming anti-FGC activities and in furthering the development and application of research methods appropriate for this subject. Several …
Training And Support Of Developing-Country Population Scientists: A Panel Report, Jane Menken, Ann K. Blanc, Cynthia B. Lloyd
Training And Support Of Developing-Country Population Scientists: A Panel Report, Jane Menken, Ann K. Blanc, Cynthia B. Lloyd
Poverty, Gender, and Youth
This report offers an assessment of the current situation and needs for the future with regard to training population professionals. As the concerns of population scientists become more diverse and as institutions look beyond the limitations of their own programs, collaborative training programs are increasingly seen as an effective means of maximizing the training experience of students while potentially lowering overall costs. While it is clear that the most desirable situation is one in which population experts are trained primarily in high-quality institutions located in their own countries or regions, it is equally clear that this scenario is not likely …
Changes In Functional Limitations And Survival Among The Elderly In Taiwan: 1993, 1996, And 1999, Zachary Zimmer, Linda G. Martin, Ming-Cheng Chang
Changes In Functional Limitations And Survival Among The Elderly In Taiwan: 1993, 1996, And 1999, Zachary Zimmer, Linda G. Martin, Ming-Cheng Chang
Poverty, Gender, and Youth
This paper focuses on changes in the prevalence of functional limitations among nationally representative samples of adults aged 65 and older in Taiwan as measured in 1993, 1996, and 1999. Using data from the Survey of Health and Living Status of the Elderly in Taiwan, we investigate changes in difficulties walking and climbing stairs, two tasks that represent basic lower body movements that are less likely to be influenced by changes in living environments and social roles than are activities of daily living and instrumental activities of daily living. Results are shown for both unadjusted prevalence rates and rates adjusted …
The Effect Of Gender Differences In Primary School Access, Type, And Quality On The Decision To Enroll In Rural Pakistan, Cynthia B. Lloyd, Cem Mete, Zeba Sathar
The Effect Of Gender Differences In Primary School Access, Type, And Quality On The Decision To Enroll In Rural Pakistan, Cynthia B. Lloyd, Cem Mete, Zeba Sathar
Poverty, Gender, and Youth
The paper explores the effect of primary school access, type, and quality on the decision to enroll in rural Pakistan using a 1997 survey especially designed for this purpose. A unique contribution of the paper is the construction of gender-specific dimensions of school accessibility and school quality according to school type (i.e., public vs. private). Within the same village, girls and boys often face starkly different options for schooling in terms of distance, type, and quality. Public primary schools are segregated by sex; private schools, whose numbers have grown rapidly in recent years in response to rising demand and the …
How Long Do We Live?, John Bongaarts, Griffith Feeney
How Long Do We Live?, John Bongaarts, Griffith Feeney
Poverty, Gender, and Youth
Period life expectancy is calculated from age-specific death rates using life table methods that are among the oldest and most fundamental tools of demography. These methods are rarely questioned, much less criticized. Yet changing age patterns of adult mortality in contemporary countries with high life expectancy provide a basis for questioning the conventional use of age-specific death rates and life tables. This paper argues that when the mean age at death is rising, period life expectancy at birth as conventionally calculated overestimates life expectancy. Estimates of this upward bias, ranging from 1.6 years for the United States and Sweden to …
Peer Education As A Strategy To Increase Contraceptive Prevalence And Reduce The Rate Of Stis/Hiv Among Adolescents In Cameroon, Institut De Recherche Et Des Etudes Des Comportements (Iresco)
Peer Education As A Strategy To Increase Contraceptive Prevalence And Reduce The Rate Of Stis/Hiv Among Adolescents In Cameroon, Institut De Recherche Et Des Etudes Des Comportements (Iresco)
Reproductive Health
The Institute for Behavioral Studies and Research completed an operations research project entitled “Among Youth” targeting adolescents in the Mokolo neighborhood of Yaoundé, Cameroon. The results presented in this report show that adolescents in Mokolo, more often than their counterparts in the control site, adopted behavioral changes to prevent STI/HIV transmission and unwanted pregnancies as a result of the intervention. The report concludes that peer education combined with mass media campaigns form an important strategy for targeting youth with reproductive health and family planning messages and can help adolescents translate knowledge into healthy lifestyles. Integration of reproductive health messages into …
Reproductive Health Care In The Postnatal Period In Guatemala, Erika Jacobs, Carlos Brambila, Ricardo Vernon
Reproductive Health Care In The Postnatal Period In Guatemala, Erika Jacobs, Carlos Brambila, Ricardo Vernon
Reproductive Health
This operations research study aimed to develop and test a job aid to provide comprehensive care to mothers and children during the first year postpartum; to train physicians, nurses, auxiliary nurses, and social workers in its use; and to develop and test strategies and materials for training community health agents to promote services for new mothers during the first year postpartum. It also collected data to establish if these strategies were effective in improving the quality and comprehensiveness of the care received by mothers and children less than one year of age. Drawing from exit interviews, the intervention appeared to …
Increasing Client Participation In Family Planning Consultations: "Smart Patient" Coaching In Indonesia, Young Mi Ki, Fitri Putjuk, Endang Basuki, Adrienne Kols
Increasing Client Participation In Family Planning Consultations: "Smart Patient" Coaching In Indonesia, Young Mi Ki, Fitri Putjuk, Endang Basuki, Adrienne Kols
Reproductive Health
In Indonesia, paternalistic models of health care, social distance between clients and service providers, and cultural norms discourage family planning clients from playing an active role in consultations. This report discusses the interventions needed to encourage clients to communicate more openly and more vigorously with providers. The study confirmed that educational interventions directed to family planning clients can help them become effective partners in their own care, assuming they meet with receptive providers. Communication interventions like Smart Patient complement and reinforce provider interpersonal communication and counseling training by giving clients the confidence and the skills to take advantage of increased …
Upgrading The Capacity And Skills Of Service Providers Of The West Bank/Gaza Pilot Health Project, Nancy Ali, Laila Nawar, Dale Huntington, Tawhida Khalil
Upgrading The Capacity And Skills Of Service Providers Of The West Bank/Gaza Pilot Health Project, Nancy Ali, Laila Nawar, Dale Huntington, Tawhida Khalil
Reproductive Health
The Center for Development in Primary Health Care (CDPHC), in collaboration with the Population Council’s FRONTIERS program, developed a 19-month training program to strengthen and improve existing maternal and children’s health and family planning services and to promote the establishment of the standardized basic package of services at Pilot Health Project (PHP) clinic sites in the West Bank and Gaza. There were four key start-up activities, including: 1) an assessment of standards of care provided at PHP clinics; 2) a review of formative research; 3) the development of clinical training manuals and curricula; and 4) the development of behavior change …
Informed Consent: From Good Intentions To Sound Practices—A Report Of A Seminar, Susan Y. Wood, Barbara Friedland, C. Elizabeth Mcgrory
Informed Consent: From Good Intentions To Sound Practices—A Report Of A Seminar, Susan Y. Wood, Barbara Friedland, C. Elizabeth Mcgrory
Reproductive Health
This report is a summary of presentations and discussions at a seminar entitled “Informed Consent: From Good Intentions to Sound Practices.” This two-day seminar brought together 65 individuals from nine countries in May 2001 to discuss challenges of informed consent in research. The goal of the meeting was to put informed consent into historical and contemporary perspective and to explore ways that the barriers to effective implementation can be overcome. The underlying premise of the seminar was that, as the issues around doing ethical research in health will only grow in scope and complexity, even when those who sponsor and …
Strategic Assessment Of Reproductive Health In The Dominican Republic, Suellen Miller, Argelia Tejada, Patricio Murgueytio
Strategic Assessment Of Reproductive Health In The Dominican Republic, Suellen Miller, Argelia Tejada, Patricio Murgueytio
Reproductive Health
This report documents the findings of a strategic assessment of reproductive health in the Dominican Republic (DR), carried out by the Ministry of Health and Social Welfare (SESPAS) and the Dominican Social Security Institute with support from the Population Council’s Expanding Contraceptive Choice (ECC) program and its Latin American and Caribbean regional offices, and the United States Agency for International Development (USAID). The USAID/DR has been working closely with SESPAS to understand the major reproductive health problems in the DR. To better assist SESPAS and to plan the country’s Reproductive Health Strategy for 2002–2007, USAID asked the Population Council’s ECC …
How Community Structures Of Time And Opportunity Shape Adolescent Sexual Behavior In South Africa, Carol E. Kaufman, Shelley Clark, Ntsiki Manzini, Julian May
How Community Structures Of Time And Opportunity Shape Adolescent Sexual Behavior In South Africa, Carol E. Kaufman, Shelley Clark, Ntsiki Manzini, Julian May
Poverty, Gender, and Youth
Recently, South Africa has led the world in rates of HIV/AIDS infection. Particularly among young adults, the prevalence of HIV has soared, now reaching 25 percent. The statistics suggest a high level of unprotected sex and risky sexual behavior even in the midst of high levels of knowledge. Research has focused on the dynamics of individuals’ and partners’ sexual decisionmaking. Little is known, however, about the larger context in which those decisions are made. What are the everyday experiences that influence risk-taking? Are young people with little to do more likely to engage in risky behavior? Do community opportunities of …
Pregnant Or Positive: Adolescent Childbearing And Hiv Risk In South Africa, Naomi Rutenberg, Carol E. Kaufman, Kate Macintyre, Lisanne Brown, Ali Mehyrar Karim
Pregnant Or Positive: Adolescent Childbearing And Hiv Risk In South Africa, Naomi Rutenberg, Carol E. Kaufman, Kate Macintyre, Lisanne Brown, Ali Mehyrar Karim
Poverty, Gender, and Youth
In communities where early age of childbearing is common and HIV prevalence is high, adolescent boys and girls may place themselves at risk of HIV to realize their childbearing preferences. In this paper, we analyze survey data from Kwa-Zulu-Natal province that explores whether an association exists between pregnancy preferences and behavioral and perceptual measures of HIV risk among adolescents in South Africa. Our analysis is based on data from 1,426 sexually active respondents aged 14-22 who participated in wave 1 of the “Transitions to Adulthood in the Context of AIDS in South Africa” study. We use logistic regression to model …
Living Arrangements And Socio-Demographic Conditions Of Older Adults In Cambodia, Zachary Zimmer, Sovan Kiry Kim
Living Arrangements And Socio-Demographic Conditions Of Older Adults In Cambodia, Zachary Zimmer, Sovan Kiry Kim
Poverty, Gender, and Youth
Since the takeover of Cambodia by the Khmer Rouge in 1975, analysis of social conditions in the country has been lacking. Only recently has dependable socio-demographic data become available. We use some of these data to examine living arrangements and other socio-demographic conditions among Cambodia’s older population and compare results to those recently found in Thailand and Vietnam. On balance, living arrangements in Cambodia are similar to those in neighboring countries. Older adults are likely to be living with a grown child and in a variety of arrangements involving different family members. To determine gender preference for coresident children we …
'Bus Fare, Please': The Economics Of Sex And Gifts Among Adolescents In Urban South Africa, Carol E. Kaufman, Stavros E. Stavrou
'Bus Fare, Please': The Economics Of Sex And Gifts Among Adolescents In Urban South Africa, Carol E. Kaufman, Stavros E. Stavrou
Poverty, Gender, and Youth
Force or coercion are often a part of sexual relationships in South Africa, especially among adolescents. This coercion is also often pinioned by an economic exchange: gifts or favours for sex. Studies have pointed out the negative consequences of the exchanges which are often characterised by large age differences (‘sugar daddies’) or power imbalances. Perhaps more pervasive but largely ignored, gift-giving in same-age relationships also may be associated with sexual leverage, an exchange which somehow entitles one partner physical and sexual rights to the other’s body. The circumstances surrounding gifts and favours may shape young women’s and men’s sexual experiences, …
Kenya: Community Sensitization Must Precede Alternative Coming-Of-Age Rite, Frontiers In Reproductive Health
Kenya: Community Sensitization Must Precede Alternative Coming-Of-Age Rite, Frontiers In Reproductive Health
Reproductive Health
Female genital cutting (FGC) is practiced as a rite of passage in over half of Kenya’s districts. Kenyan nongovernmental agency Maendeleo Ya Wanawake (MYWO) has long conducted community sensitization focused on discouraging this practice. In 1996, MYWO began implementing the “alternative rite” (AR) intervention in sensitized communities. Girls participating in AR receive family life education in seclusion, followed by a public graduation ceremony recognizing them as adults. They are not cut as part of the ceremony. In 2000, the Population Council carried out an assessment of the AR program that sought to identify the impact of MYWO’s activities on knowledge …
Zimbabwe: Cbd Roles Modified To Address Zimbabwe's Hiv/Aids Crisis, Frontiers In Reproductive Health
Zimbabwe: Cbd Roles Modified To Address Zimbabwe's Hiv/Aids Crisis, Frontiers In Reproductive Health
Reproductive Health
In September 1999, the Zimbabwe National Family Planning Council (ZNFPC) and the Population Council initiated a one-year study to assess the performance of ZNFPC’s community-based distribution (CBD) program. A continual decline in the program’s productivity, combined with the expanding HIV/AIDS epidemic, indicated a need to reconsider ZNFPC’s objectives and revise the roles and responsibilities of its full-time, salaried CBD agents. The study examined the productivity, costs, and potential sustainability of the CBD program. Researchers gathered information by reviewing program documents through 1999. They also interviewed program managers, district and community nurses, and community leaders and CBD agents from eight regions. …
The Elderly And Aids: Coping Strategies And Health Consequences In Rural Tanzania, Julia Dayton, Martha Ainsworth
The Elderly And Aids: Coping Strategies And Health Consequences In Rural Tanzania, Julia Dayton, Martha Ainsworth
Poverty, Gender, and Youth
The elderly are often especially likely to be adversely affected by the death from AIDS of prime-aged adults. The authors use a longitudinal survey of households from northwestern Tanzania in 1991-94 to compare the activities and wellbeing of the elderly in households before and after the death of a prime-aged adult with those of the elderly in households that did not experience the death of an adult. A significant proportion of adults suffering from AIDS return to their parents’ home shortly before death. Time spent by the elderly performing household chores rises following an adult’s death, and their participation in …
Premarital Sex In Vietnam: Is The Current Concern With Adolescent Reproductive Health Warranted?, Barbara Mensch, Wesley H. Clark, Dang Nguyen Anh
Premarital Sex In Vietnam: Is The Current Concern With Adolescent Reproductive Health Warranted?, Barbara Mensch, Wesley H. Clark, Dang Nguyen Anh
Poverty, Gender, and Youth
To the extent that research on Vietnamese adolescents has been conducted, it has been concerned with unprotected and unsanctioned sexual activity and its health consequences, namely abortion and sexually transmitted diseases, especially HIV. The question we pose is whether this concern is warranted. Is the population community justified in focusing its attention on early sexual activity and HIV risk? Even if the sexual behavior of young people can be considered problematic, are there perhaps other aspects of young people’s lives that should give us greater pause? The paper reviews the literature on adolescent sexual behavior in Vietnam and analyzes data …
Training And Support Of Developing-Country Population Scientists: A Panel Report—Summary And Recommendations, Jane Menken, Ann K. Blanc, Cynthia B. Lloyd
Training And Support Of Developing-Country Population Scientists: A Panel Report—Summary And Recommendations, Jane Menken, Ann K. Blanc, Cynthia B. Lloyd
Poverty, Gender, and Youth
From its earliest days, the Population Council has recognized the importance and value of training population scientists from developing countries. Since 1952, the Council’s social science fellowship program has sustained a commitment to this goal; approximately 1,500 fellowships have been awarded for pre- and postdoctoral training in population studies. While the demand for population scientists remains strong, the field has changed substantially since those early years and a review of the program was needed. The Mellon Foundation funded a project in 2000 to assess future needs for training and support of population scientists from developing countries and assembled an international …
Sustainability Of Postabortion Care In Peru, Janie Benson, Victor Huapaya
Sustainability Of Postabortion Care In Peru, Janie Benson, Victor Huapaya
Reproductive Health
The goal of this study was to determine the sustainability of the postabortion care (PAC) training and service delivery intervention introduced in the Hospital Nacional Daniel Alcides Carrión in Lima, Peru, and the extent to which the outcomes of the intervention have continued. The objectives of the study were to assess changes over time in the following outcomes: the use of manual vacuum aspiration for incomplete abortion, provision of family planning information to postabortion patients, acceptance of contraception by postabortion patients prior to discharge, provision of medical care information to patients, length of hospital stay, and resources used by the …
Demographic Factors In East Asian Regional Integration, Geoffrey Mcnicoll
Demographic Factors In East Asian Regional Integration, Geoffrey Mcnicoll
Poverty, Gender, and Youth
The Remapping Asia project, to which this paper is a contribution, investigates broad spatial changes in the ways that East Asia’s political and social life are organized and economies operate. Such changes are attributable to planned action of governments, firms, and other organized groups and to the unorganized but in some measure predictable behavior of myriad families and individuals. The project’s particular interest is in processes of regionalization-both through the deliberate construction of political institutions and through the largely unplanned emergence of regional affiliations and identities. Demographic factors play a potentially significant part both in promoting and in impeding regional …