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Demand For And Access To Family Planning Services Among Young Married Women During Covid-19 Crisis, Unicef, Population Council Institute Jul 2020

Demand For And Access To Family Planning Services Among Young Married Women During Covid-19 Crisis, Unicef, Population Council Institute

Poverty, Gender, and Youth

In Bihar, India, as a result of the COVID-19 lockdown and men returning home in large numbers and spending more time at home in high stress conditions, the need for contraceptive services could get greater. March to May are considered the “lean season” when demand is typically low for family planning (FP) programs in states like Bihar. However, higher demand caused by the lockdown and lack of access to health facilities has created a gap between demand and uptake. This could have negative consequences such as high numbers of unintended pregnancies, unsafe abortions, and maternal mortality. Current use of modern …


Understanding Factors Influencing Adverse Sex Ratios At Birth In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Md. Irfan Hossain, Forhana Rahman Noor Jan 2015

Understanding Factors Influencing Adverse Sex Ratios At Birth In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Md. Irfan Hossain, Forhana Rahman Noor

Poverty, Gender, and Youth

Nationally, the sex ratio at birth has persisted at its natural level of 105 male per 100 female newborns for the past half century in Bangladesh. However, at the regional level, Bangladesh is characterized by an east-west divide in sex ratios at birth. While the western region shows normal sex ratios at birth, the eastern region displays distorted sex ratios. To understand the factors that contribute to regional variations, a household survey was conducted among married women aged 18–49 years who had at least two living children. Views of health-care providers on gender-biased sex selection and of program implementers on …


Addressing Gender-Biased Sex Selection In Haryana, India: Promising Approaches, Shireen J. Jejeebhoy, Rajib Acharya, Sharmistha Basu, A.J. Francis Zavier Jan 2015

Addressing Gender-Biased Sex Selection In Haryana, India: Promising Approaches, Shireen J. Jejeebhoy, Rajib Acharya, Sharmistha Basu, A.J. Francis Zavier

Poverty, Gender, and Youth

Persistently adverse sex ratios remain a challenge in India despite the enforcement of the PCPNDT (Pre-Conception and Pre-Natal Diagnostic Techniques) Act in 1994. Nevertheless, over the decade 2001–2011, positive shifts from very adverse to less adverse levels have occurred in a few states. Two districts in Haryana state—Kurukshetra and Sonipat—whose sex ratios displayed some and no improvement, respectively, are compared in an attempt to find promising programme directions to counter gender-biased sex selection. Comparisons are drawn from the attitudes and experiences of surveyed women and interviews with service providers and programme implementers, about sex-selection technology. Also addressed are differences in …


Unveiling The Consensus: Putting People First In Pakistan's Development Agenda, Government Of Pakistan, Unfpa, Population Council Jan 2015

Unveiling The Consensus: Putting People First In Pakistan's Development Agenda, Government Of Pakistan, Unfpa, Population Council

Poverty, Gender, and Youth

This document contains the consensus from the Population Summit held in Islamabad, Pakistan, November 5–6, 2015. To date, an enduring commitment to a sound and adequate population welfare program has eluded Pakistan, leaving millions of couples who want to wait before having their next child or who consider that they have enough children, without good access to family planning. However, in the wake of devolution, in part through efforts of donors and civil society for awareness building, advocacy, and dialogue, opinion among all major stakeholders is coalescing around the need to address Pakistan’s alarming maternal and child health indicators through …


Curriculum On Adolescent-Friendly Health Services And Health Voucher Mechanisms: Facilitator's Training Manual, Population Council Jan 2015

Curriculum On Adolescent-Friendly Health Services And Health Voucher Mechanisms: Facilitator's Training Manual, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Empowerment Program (AGEP) in rural and urban Zambia aims to build social, health, and economic assets of adolescent girls. A safe spaces component is at the core of AGEP. Girls groups, under the guidance of a female mentor from the same community, provide a safe and supportive learning environment. The meetings are critical in building social assets for vulnerable girls—including friendships, self-esteem, trusting relationships with adults, and social support. The training content over the course of the year varies from sexual and reproductive health and life skills to financial education and nutrition training. Girls in AGEP receive …


Accelerating Reproductive And Child Health Program Development: The Navrongo Initiative In Ghana, James F. Phillips, Ayaga A. Bawah, Fred N. Binka Jan 2005

Accelerating Reproductive And Child Health Program Development: The Navrongo Initiative In Ghana, James F. Phillips, Ayaga A. Bawah, Fred N. Binka

Poverty, Gender, and Youth

Successive global health and development agendas have been embraced by African governments—Alma Ata in 1978, the Bamako Initiative in 1987, the 1994 Cairo International Conference on Population and Development, and more recently the Millennium Development Goals (MDGs)—only to be followed by widespread implementation failure. This paper presents an approach to program development in Ghana that is using research to accelerate policy implementation. Originally launched in 1994 as a participatory pilot project of the Navrongo Health Research Centre, a controlled experimental study was initiated in 1996 to assess the fertility and child-survival impact of alternative community health and family planning service …


The Effect Of Community Nurses And Health Volunteers On Child Mortality: The Navrongo Community Health And Family Planning Project, Brian Wells Pence, Philomena Nyarko, James F. Phillips, Cornelius Debpuur Jan 2005

The Effect Of Community Nurses And Health Volunteers On Child Mortality: The Navrongo Community Health And Family Planning Project, Brian Wells Pence, Philomena Nyarko, James F. Phillips, Cornelius Debpuur

Poverty, Gender, and Youth

This report presents the child mortality impact of a trial of primary health-care service-delivery strategies in rural Ghana. After adjustment for sociodemographic factors, under-five mortality in areas with village-based community-nurse services fell by 16 percent during the five years of program implementation compared with mortality before the intervention. Reductions were observed in infant (6 percent), early child (20 percent), and late child (41 percent) mortality. Community involvement and training of a local health volunteer were associated with an 11 percent increase in mortality, primarily driven by a 124 percent increase in early child mortality. Areas with both nurses and volunteers …


Completing The Fertility Transition In The Developing World: The Role Of Educational Differences And Fertility Preferences, John Bongaarts Jan 2003

Completing The Fertility Transition In The Developing World: The Role Of Educational Differences And Fertility Preferences, John Bongaarts

Poverty, Gender, and Youth

This study summarizes patterns of educational differentials in wanted and unwanted fertility at different stages of the fertility transition based on data from DHS surveys in 57 less developed countries. As the transition proceeds, educational differentials in wanted fertility tend to decline and differentials in unwanted fertility tend to rise. An assessment of fertility patterns in more and less developed countries with low fertility concludes that these differentials are likely to remain substantial when less developed countries reach the end of their transitions. This finding implies that the educational composition of the population remains a key predictor of overall fertility …


Completing The Fertility Transition In The Developing World: The Role Of Educational Differences And Fertility Preferences [Arabic], John Bongaarts Jan 2003

Completing The Fertility Transition In The Developing World: The Role Of Educational Differences And Fertility Preferences [Arabic], John Bongaarts

Poverty, Gender, and Youth

This study summarizes patterns of educational differentials in wanted and unwanted fertility at different stages of the fertility transition based on data from DHS surveys in 57 less developed countries. As the transition proceeds, educational differentials in wanted fertility tend to decline and differentials in unwanted fertility tend to rise. An assessment of fertility patterns in more and less developed countries with low fertility concludes that these differentials are likely to remain substantial when less developed countries reach the end of their transitions. This finding implies that the educational composition of the population remains a key predictor of overall fertility …


Evidence-Based Development Of Health And Family Planning Programs In Bangladesh And Ghana, James F. Phillips, Tanya C. Jones, Frank K. Nyonator, Shruti Ravikumar Jan 2003

Evidence-Based Development Of Health And Family Planning Programs In Bangladesh And Ghana, James F. Phillips, Tanya C. Jones, Frank K. Nyonator, Shruti Ravikumar

Poverty, Gender, and Youth

This paper describes two initiatives that have used experimental studies to guide the development of community-based health and family planning programs. In Bangladesh and Ghana, factorial experiments were implemented in stages. An exploratory phase developed a service system for community-based health care; an experimental phase assessed the demographic impact of the system; a replication phase examined the transferability of the experimental program to a non-research setting; and a scaling-up phase facilitated the extension of the new system to the national health care program. All stages were guided by research, with questions, mechanisms, and outcomes shifting as the process developed. Large-scale …


Social Organization And Reproductive Behavior In Southern Ghana, Dominic K. Agyeman, John B. Casterline Jan 2002

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 …


What About Us? Bringing Infertility Into Reproductive Health Care, Okonofua Friday, Bishakha Datta Jan 2002

What About Us? Bringing Infertility Into Reproductive Health Care, Okonofua Friday, Bishakha Datta

Poverty, Gender, and Youth

Infertility is a major reproductive health problem throughout much of the world. Despite the prevalence and seriousness of infertility, the population and reproductive health field has largely neglected this problem. National policies and international donor organizations have been one-sided in their focus on programs designed to prevent unwanted pregnancies. This issue of Quality/Calidad/Qualité, with clinic-based narratives and case reports from India and Nigeria, illustrates what is involved in trying to address the problem of infertility in developing countries. A possible framework for incorporating limited infertility care into a family planning or reproductive health program includes providing education and counseling, preliminary …


The End Of The Fertility Transition In The Developed World, John Bongaarts Jan 2001

The End Of The Fertility Transition In The Developed World, John Bongaarts

Poverty, Gender, and Youth

By the late 1990s fertility in the developed world had declined to 1.6 births per woman, a level substantially lower than projected in the 1980s. This study examines recent trends and patterns in fertility in the developed world with particular emphasis on the effects and implications of changes in the timing of childbearing. The main objective is to demonstrate that while fertility in these countries is indeed low, women’s childbearing levels are not as low as period measures such as the total fertility rate suggest. To obtain a full understanding of the various dimensions of fertility change, several indicators are …


Future Trends In Contraception In The Developing World: Prevalence And Method Mix, John Bongaarts, Elof D.B. Johansson Jan 2000

Future Trends In Contraception In The Developing World: Prevalence And Method Mix, John Bongaarts, Elof D.B. Johansson

Poverty, Gender, and Youth

The main objectives of this study are to review existing methodologies for projecting future trends in contraception, evaluate the validity of the assumptions underlying these projections, propose methodological improvements, and assess the prospects for new methods of contraception in the coming decade. The prevalence of contraception in the developing world has increased dramatically over the past several decades from near zero to around 60 percent in 2000. Demand for contraception can be expected to continue to rise rapidly for the next few decades as population size continues to grow and fertility declines further to near the replacement level. As a …


Some Preconditions For Fertility Decline In Bengal: History, Language Identity, And An Openness To Innovations, Alaka Malwade Basu, Sajeda Amin Jan 2000

Some Preconditions For Fertility Decline In Bengal: History, Language Identity, And An Openness To Innovations, Alaka Malwade Basu, Sajeda Amin

Poverty, Gender, and Youth

This paper argues that looking solely for the immediate causes of reproductive change may fail to take into account not only the impact of policies and programs but the societal decision to adopt these policies and programs to begin with. The paper examines the historical origins and spread of ‘modern’ ideas in Bangladesh and the state of West Bengal in India. It concludes that a colonial history in which education and modernization processes took hold very early among the elite in the larger Bengal region was paradoxically accompanied by a strong allegiance to the Bengali language. This strong sense of …


Unmet Need For Family Planning In Developing Countries And Implications For Population Policy, John B. Casterline, Steven W. Sinding Jan 2000

Unmet Need For Family Planning In Developing Countries And Implications For Population Policy, John B. Casterline, Steven W. Sinding

Poverty, Gender, and Youth

Unmet need for family planning has been a core concept in international population discourse for several decades. In this paper we reevaluate its utility. We review the history of unmet need and the development of increasingly refined methods of its empirical measurement. We then turn to the main questions that have been raised about unmet need during the past decade, some of which concern the validity of the concept and others its role in the post-ICPD environment. The discussion draws heavily on empirical research conducted during the 1990s, much of it localized, in-depth studies combining quantitative and qualitative methodologies, that …


Unmet Need For Family Planning In Developing Countries And Implications For Population Policy [Arabic], John B. Casterline, Steven W. Sinding Jan 2000

Unmet Need For Family Planning In Developing Countries And Implications For Population Policy [Arabic], John B. Casterline, Steven W. Sinding

Poverty, Gender, and Youth

Unmet need for family planning has been a core concept in international population discourse for several decades. In this paper we reevaluate its utility. We review the history of unmet need and the development of increasingly refined methods of its empirical measurement. We then turn to the main questions that have been raised about unmet need during the past decade, some of which concern the validity of the concept and others its role in the post-ICPD environment. The discussion draws heavily on empirical research conducted during the 1990s, much of it localized, in-depth studies combining quantitative and qualitative methodologies, that …


Spatial Variation In Contraceptive Use In Bangladesh: Looking Beyond The Borders, Sajeda Amin, Alaka Malwade Basu, Rob Stephenson Jan 2000

Spatial Variation In Contraceptive Use In Bangladesh: Looking Beyond The Borders, Sajeda Amin, Alaka Malwade Basu, Rob Stephenson

Poverty, Gender, and Youth

This paper tries to promote a more complete understanding of social change by analyzing spatial patterns of contraceptive use in Bangladesh and the contiguous state of West Bengal in India. The paper takes it’s cue from earlier analysis which found strong evidence of higher contraceptive prevalence in districts of Bangladesh that border Bengali speaking districts on India, as well as from analysis of fertility decline in historical Europe where language played a critical role. Using multilevel analysis to control for variations in individual and household level correlates, mapping districts that deviate considerably from their regional averages, the analysis highlights an …


Adolescent Pregnancy And Parenthood In South Africa, Carol E. Kaufman, Thea De Wet, Jonathan Stadler Jan 2000

Adolescent Pregnancy And Parenthood In South Africa, Carol E. Kaufman, Thea De Wet, Jonathan Stadler

Poverty, Gender, and Youth

South Africa’s total fertility rate is estimated to be one of the lowest in sub-Saharan Africa, less than 3.0 births per woman nationally and declining. At the same time, adolescent childbearing levels remain high more than 30 percent of 19-year-old girls are reported to have given birth at least once. Using evidence from focus groups conducted in urban and rural areas in South Africa with young black women and men, and with the parents of teenage mothers, we consider the experience of early parenthood. Specifically, the analysis explores four aspects of teenage childbearing as it relates to key transitions into …


Completing The Demographic Transition, John Bongaarts, Rodolfo A. Bulatao Jan 1999

Completing The Demographic Transition, John Bongaarts, Rodolfo A. Bulatao

Poverty, Gender, and Youth

Despite ongoing declines in fertility in many countries, the population of the world is experiencing a period of rapid expansion, and its size is expected to exceed 10 billion by the end of the demographic transition. Three causes of this growth are identified and quantified: 1) fertility above the replacement level of two surviving children per woman, 2) continuing declines in mortality, and 3) population momentum resulting from a young age structure. A set of simple analytic expressions is proposed for estimating these factors from standard demographic indicators. Population momentum is shown to be the main cause of future growth …


Measuring Living Standards With Proxy Variables, Mark R. Montgomery, Michele Gragnolati, Kathleen A. Burke, Edmundo Paredes Jan 1999

Measuring Living Standards With Proxy Variables, Mark R. Montgomery, Michele Gragnolati, Kathleen A. Burke, Edmundo Paredes

Poverty, Gender, and Youth

Very few demographic surveys in developing countries gather information on household income or consumption expenditure, despite the theoretical importance of these measures. Consequently, researchers have been forced to rely on ad hoc collections of proxy measures for living standards, and the properties of these proxies have not been systematically analyzed. In this research, we ask what hypotheses can be tested using proxy variables, and evaluate the performance of proxy measures in relation to consumption expenditures per adult, our preferred measure of living standards. We find that the proxy variables commonly employed in demographic research are very weak predictors of consumption …


Fertility Preferences And Contraceptive Change In Developing Countries, Bamikale J. Feyisetan, John B. Casterline Jan 1999

Fertility Preferences And Contraceptive Change In Developing Countries, Bamikale J. Feyisetan, John B. Casterline

Poverty, Gender, and Youth

Fertility has declined substantially in developing countries in the period since 1960, primarily as the result of increases in contraceptive prevalence. Little dispute is found on this point, but considerable debate has arisen about the causes of the increase in contraceptive prevalence. One unresolved issue is the causal contribution of changes in fertility desires. The sources of increase in contraceptive prevalence are analyzed in 22 countries in Latin America, Asia, and Africa in the period from the 1970s to the 1990s, using World Fertility Surveys and Demographic and Health Surveys data. Through regression decomposition, change in prevalence is attributed to …


The Fertility Impact Of Changes In The Timing Of Childbearing In The Developing World, John Bongaarts Jan 1999

The Fertility Impact Of Changes In The Timing Of Childbearing In The Developing World, John Bongaarts

Poverty, Gender, and Youth

This study examines the role of tempo effects in the fertility declines of developing countries. These effects temporarily inflate the total fertility rate (relative to the actual fertility of cohorts of women) during periods when the age at childbearing declines and they deflate it when childbearing is postponed. An analysis of data from the World Fertility Surveys and the Demographic and Health Surveys demonstrates that fertility trends observed in many developing countries are likely to be distorted by changes in the timing of childbearing. In most countries women are delaying childbearing, which implies that observed fertility is lower than it …


Lessons From Community-Based Distribution Of Family Planning In Africa, James F. Phillips, Wendy L. Greene, Elizabeth F. Jackson Jan 1999

Lessons From Community-Based Distribution Of Family Planning In Africa, James F. Phillips, Wendy L. Greene, Elizabeth F. Jackson

Poverty, Gender, and Youth

This paper reviews findings and experiences from efforts to implement community-based family planning services in sub-Saharan Africa. Although research suggests that community-based service delivery can contribute to contraceptive use, the magnitude of impact is often in doubt or is considerably less than was observed in similar projects in Asia in the 1970s and 1980s. Reasons for the constrained impact of community-based family planning in Africa are reviewed and assumptions about the efficacy and mechanism of community-based distribution (CBD) are discussed. Whereas several contrasting approaches to CBD have been tried, little is known about the relative merits of alternative CBD approaches.


Population Weights In The International Order, Geoffrey Mcnicoll Jan 1999

Population Weights In The International Order, Geoffrey Mcnicoll

Poverty, Gender, and Youth

Population relativities play little part in the international system. A nation’s economic and military power is influenced by population size, but as one factor among many. Formal relations among states exclude population from consideration by the principle of sovereign equality. Three sources of possible change in this situation are explored, in which states would be “population-weighted” to a greater degree than before. Convergence of productivity levels around the world, expected by many, would bring the economic and population rankings of states more into line. Such convergence is occurring, but selectively and for the most part quite slowly. Anticipation of its …


The Quantity-Quality Transition In Asia, Mark R. Montgomery, Mary Arends-Kuenning, Cem Mete Jan 1999

The Quantity-Quality Transition In Asia, Mark R. Montgomery, Mary Arends-Kuenning, Cem Mete

Poverty, Gender, and Youth

Societies in which fertility is falling and human capital investment per child increasing are experiencing a “quantity-quality transition.” Such transitions imply, over the long term, both slower rates of labor force growth and higher levels of human capital per worker. They are fundamental to economic development. Yet, these transitions are neither automatic or self-propelling. Their momentum depends on competing forces acting at both the family and the macroeconomic levels; the balance can easily tip against further transition. Family decisions about schooling are largely motivated by its private economic returns. These returns are determined in labor markets, and here the logic …


The Spread Of Primary Schooling In Sub-Saharan Africa: Implications For Fertility Change, Cynthia B. Lloyd, Carol E. Kaufman, Paul C. Hewett Jan 1999

The Spread Of Primary Schooling In Sub-Saharan Africa: Implications For Fertility Change, Cynthia B. Lloyd, Carol E. Kaufman, Paul C. Hewett

Poverty, Gender, and Youth

Caldwell has hypothesized that the onset of the fertility transition would be linked with the achievement of “mass formal schooling.” In sub-Saharan Africa, a region where some countries have begun the fertility transition but many have not, the extent of progress toward mass schooling has not yet been assessed. This paper fills a gap in the literature using newly available Demographic and Health Survey data to assess schooling patterns and trends for 17 sub-Saharan African countries. As background to that assessment, the paper includes a literature review, an overview of the recent history of African education, and an evaluation of …


Fertility And Reproductive Preferences In Post-Transitional Societies, John Bongaarts Jan 1998

Fertility And Reproductive Preferences In Post-Transitional Societies, John Bongaarts

Poverty, Gender, and Youth

Conventional theories have little to say about the level at which fertility will stabilize at the end of the transition although it is often assumed that replacement fertility of about 2.1 births per woman will prevail in the long run. However, fertility has dropped below the replacement level in virtually every population that has moved through the demographic transition. If future fertility remains at these low levels populations will decline in size and age rapidly.This paper attempts to contribute to the understanding of levels and trends of post-transitional fertility by examining the causes of discrepancies between reproductive preferences and observed …


The Impact Of Family Planning Household Service Delivery On Women's Status In Bangladesh, James F. Phillips, Mian Bazle Hossain Jan 1998

The Impact Of Family Planning Household Service Delivery On Women's Status In Bangladesh, James F. Phillips, Mian Bazle Hossain

Poverty, Gender, and Youth

Since 1982, the Maternal and Child Health and Family Planning Extension Project has compiled longitudinal panel data on rural women’s contact with household service providers who visit homes to discuss family planning and offer services to women on request. This study tests the hypothesis that home-based services reinforce customs of purdah (female seclusion) by sustaining the dependency and isolation of the women served by the program. Results show that household services improve women’s status. This effect is largely attributable to the impact of outreach on effective fertility regulation. Findings do not support the hypothesis that household service delivery is detrimental …


Government And Fertility In Transitional And Post-Transitional Societies, Geoffrey Mcnicoll Jan 1998

Government And Fertility In Transitional And Post-Transitional Societies, Geoffrey Mcnicoll

Poverty, Gender, and Youth

Five categories of possible government influence on a nation’s fertility are explored: (1) through publicly funded programs that explicitly seek to affect family-size outcomes (2) through the legal order and system of public administration (3) through measures that affect economic opportunity, social mobility, and gender relations; (4) through public-sector expenditures and transfer payments keyed to age or family status; and (5) through the state’s supplanting of local beliefs and traditions with the symbols of national identity and through the parallel expansion of cultural frames of reference. Aside from the first of these, intentions to influence fertility are either incidental or …