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Articles 541 - 570 of 1748
Full-Text Articles in Demography, Population, and Ecology
Availability, Use And Quality Of Care For Medical Abortion Services In Private Facilities In Kenya, Wilson Liambila, Francis Obare, Edward Ikiugu, Vitalis Akora, Jesse Njunguru, Michael Njuma, Kate Reiss, Harriet Birungi
Availability, Use And Quality Of Care For Medical Abortion Services In Private Facilities In Kenya, Wilson Liambila, Francis Obare, Edward Ikiugu, Vitalis Akora, Jesse Njunguru, Michael Njuma, Kate Reiss, Harriet Birungi
Reproductive Health
The overall goal of this study was to generate evidence on the availability, use, and quality of care for medical abortion services in private facilities (pharmacies and clinics) in Kenya. With the passing of a new constitution in 2010, there was renewed interest in the right to health and the need to reduce the high levels of maternal morbidity and mortality arising from unsafe abortion in the country. In spite of recent developments, there is limited understanding of the extent to which the changes have influenced the provision of medical abortion information and services in the country, the acceptability of …
Introducing Antiretroviral (Arv)-Based Prevention Products For Women: A Guide To Strategic Decisionmaking And Planning, Population Council
Introducing Antiretroviral (Arv)-Based Prevention Products For Women: A Guide To Strategic Decisionmaking And Planning, Population Council
HIV and AIDS
As evidence mounts that antiretrovirals (ARVs) are effective for HIV prevention, policymakers and program managers will need to determine whether and how best to introduce specific products into health care systems. Determining the most appropriate users within a particular country will depend on the overall context, the nature of the HIV epidemic within the country, and the opportunities available to reach and serve HIV-negative women with ARV-based prevention products and services. This toolkit was developed by the Population Council for use by governments, organizations, and donors who are in a position to support or add new HIV-prevention products into programs. …
Burundi Program Implementation Workshop, 3–5 June 2014: Link Up Meeting Report, Population Council, Alliance Burundaise Contre Le Sida
Burundi Program Implementation Workshop, 3–5 June 2014: Link Up Meeting Report, Population Council, Alliance Burundaise Contre Le Sida
HIV and AIDS
Link Up is a global consortium of international and local nongovernmental organizations led by the International HIV/AIDS Alliance. Link Up aimed to improve the sexual and reproductive health and rights of young people in Bangladesh, Burundi, Ethiopia, Myanmar, and Uganda who are living with HIV or are affected by the HIV pandemic. At a workshop held in Burundi, 3–5 June 2014, the Population Council, Alliance Burundaise contre le SIDA, and local partners in Burundi identified successful activities, highlighted important challenges and best practices, and found innovative ways to improve Link Up programming. This document contains a selection of the most …
Expanding Young People's Access To Integrated Services In Malawi, Integra Initiative
Expanding Young People's Access To Integrated Services In Malawi, Integra Initiative
Reproductive Health
In sub-Saharan Africa, uptake of sexual and reproductive health (SRH) services among young people remains low, placing millions of young people at risk of poor reproductive health outcomes and sexually transmitted infections, including HIV. The “Steps to Integration” series provides a guide on how to integrate HIV and SRH services based on findings from the Integra Initiative, managed by the International Planned Parenthood Federation in partnership with the London School of Hygiene & Tropical Medicine and the Population Council. Issue 7 of the series focuses on expanding young people’s access to integrated services in Malawi. Conclusions include: improving the quality …
Delivering Contraceptive Vaginal Rings—Task Sharing Policies And Practices In The Delivery Of Family Planning Services: Experiences From Nigeria, Godwin Unumeri, Salisu Mohammed Ishaku
Delivering Contraceptive Vaginal Rings—Task Sharing Policies And Practices In The Delivery Of Family Planning Services: Experiences From Nigeria, Godwin Unumeri, Salisu Mohammed Ishaku
Reproductive Health
Despite tremendous progress over the past decades in family planning and fertility reduction, more than 220 million women have unmet need for contraception globally. The government of Nigeria pledged over $11 million to procure contraceptive commodities for distribution in the public sector from 2011–2015, to increase the contraceptive prevalence rate (CPR) that had stalled at 10 percent for almost two decades. The Population Council is facilitating the registration, introduction, and scale-up of the Progesterone Contraceptive Vaginal Ring (PCVR), designed particularly for breastfeeding women, in the sub-Saharan African countries of Kenya, Nigeria, and Senegal. In Nigeria, restrictive policies regarding matching health …
Promoting Respectful Maternity Care Resource Package—Maternity Open Days: Clarifying Misconceptions About Childbirth, Population Council
Promoting Respectful Maternity Care Resource Package—Maternity Open Days: Clarifying Misconceptions About Childbirth, Population Council
Reproductive Health
Fear of disrespect and abuse along with misconceptions about procedures required to assist women during childbirth often negatively influence the decision to seek care at a health facility. Maternity Open Days provide an opportunity for pregnant women and their families to interact with health care providers and visit maternity units to demystify birthing practices and mitigate fears regarding childbirth in a facility. Such an approach brings together women, their families, and providers to enable pregnant women to understand what happens in a maternity unit. This brief is part of a Respectful Maternity Care Resource Package developed by the Kenya Heshima …
Invest In Urban Youth Sexual And Reproductive Health To Achieve A Demographic Dividend In Africa, Joyce Mumah, Jessica Brinton, Carol Mukiira, Caroline W. Kabiru, Chimaraoke O. Izugbara
Invest In Urban Youth Sexual And Reproductive Health To Achieve A Demographic Dividend In Africa, Joyce Mumah, Jessica Brinton, Carol Mukiira, Caroline W. Kabiru, Chimaraoke O. Izugbara
Reproductive Health
The future of Africa depends on its ability to harness the potential of its young people. Making the right investments in youth—particularly those in urban areas—can enable the region to experience substantial economic growth and sustainable national development for current and future generations. This policy brief reports on a number of recommendations to help African governments and Ministries of Health and Education realize the demographic dividend; incorporate economic empowerment programs into urban programming and budget allocation; integrate training on the provision of quality and effective youth-friendly services for health workers; and revitalize school health programming.
Understanding The Reproductive Health Needs Of Adolescents In Selected Slums In Ghana: A Public Health Assessment, Selina F. Esantsi, Francis Onyango, Gloria Quansah Asare, Emmanuel Kuffour, Placide Tapsoba, Harriet Birungi, Ian Askew
Understanding The Reproductive Health Needs Of Adolescents In Selected Slums In Ghana: A Public Health Assessment, Selina F. Esantsi, Francis Onyango, Gloria Quansah Asare, Emmanuel Kuffour, Placide Tapsoba, Harriet Birungi, Ian Askew
Reproductive Health
Over the past decade, adolescent sexual and reproductive health (ASRH) concerns have increasingly been on the development agenda of the government of Ghana. This concern has been driven by such factors as early age of sexual debut, early childbearing, and prevalence of HIV/AIDS among this subgroup of the population. The overall objective of the study was to generate evidence on the knowledge, perceptions, and practices regarding ASRH among slum communities in Ghana. The findings of the study indicate a need for intensifying efforts to inform and educate adolescents living in the slums about responsible and healthy attitudes toward sexuality, delaying …
Sexual Health And Hiv Risk Behaviors Of Men Who Have Sex With Men In Myanmar—Baseline Findings From Link Up, Population Council, Burnet Institute
Sexual Health And Hiv Risk Behaviors Of Men Who Have Sex With Men In Myanmar—Baseline Findings From Link Up, Population Council, Burnet Institute
HIV and AIDS
In 2013, an estimated 189,000 people were living with HIV in Myanmar. The overall adult HIV prevalence is estimated to be around 0.5 percent, but key populations such as men who have sex with men (MSM) bear a disproportionate disease burden. According to national estimates, HIV prevalence among MSM is 20 times higher than in the general population, at 10 percent. Effective, targeted, innovative, and culturally appropriate interventions that have been shown to significantly reduce high-risk sexual behaviors among MSM are needed to reduce the HIV burden among this population. In Myanmar, as part of the Link Up project, Alliance …
Reach: Randomized Evaluation Of Hiv/Fp Service Models, Paul C. Hewett, Mutinta Nalubamba, Fiammetta Bozzani, Mardieh Dennis, Jean Digitale, Lung Vu, Eileen Yam, Mary Nambao
Reach: Randomized Evaluation Of Hiv/Fp Service Models, Paul C. Hewett, Mutinta Nalubamba, Fiammetta Bozzani, Mardieh Dennis, Jean Digitale, Lung Vu, Eileen Yam, Mary Nambao
HIV and AIDS
The REacH (Randomized Evaluation of HIV/FP Service Models) project compares health service uptake of two models for HIV prevention and family planning service linkage and integration. This report details results which indicate that the enhanced client add-on service referral and follow-up arm with and without the escort increased the uptake of HIV testing and counseling services among women who had entered at family planning care entry points. The effect of the intervention was greater in the shorter term, improving uptake within six weeks, but nonetheless remained important through six months. The results indicate that the intervention can increase the numbers …
Reducing Maternal And Child Mortality In Khyber Pakhtunkhwa: The Untapped Potential Of Family Planning, Zeba Sathar, Maqsood Sadiq, Seemin Ashfaq
Reducing Maternal And Child Mortality In Khyber Pakhtunkhwa: The Untapped Potential Of Family Planning, Zeba Sathar, Maqsood Sadiq, Seemin Ashfaq
Reproductive Health
Family Planning (FP) is recognized as a necessary tool for faster fertility decline leading to accelerated economic development. However, its unique and potent role in preserving mother and child health is less well understood. This Population Council/Evidence Project policy brief explains why family planning must be prioritized in Khyber Pakhtunkhwa, Pakistan’s health strategy as a key intervention for reducing maternal, infant, and under-five mortality in the province. By fulfilling the existing unmet need for birth spacing and limiting, it is possible to prevent 37 percent of maternal deaths and 57 percent of infant deaths. FP’s wider health benefits include reduced …
Prospects For Economic Growth In Khyber Pakhtunkhwa Under Alternative Demographic Scenarios: The Case For A Rapid Fertility Decline, David E. Bloom, Zeba Sathar, Maqsood Sadiq
Prospects For Economic Growth In Khyber Pakhtunkhwa Under Alternative Demographic Scenarios: The Case For A Rapid Fertility Decline, David E. Bloom, Zeba Sathar, Maqsood Sadiq
Reproductive Health
Khyber Pakhtunkhwa (KP) is currently undergoing a demographic transition from a situation of high fertility and high mortality to one of lower fertility and mortality. The resulting bulge in its working-age population means the province is poised to reap a “demographic dividend.” By 2050, KP’s per capita income will be 167 percent higher than today’s levels if there is no decline in fertility, but 412 percent higher if fertility declines rapidly. The scale and effectiveness of efforts to reduce fertility levels in KP will determine whether per capita income in the province grows by 316 percent or by 412 percent …
Utilization Of National Health Insurance For Family Planning And Reproductive Health Services By The Urban Poor In Uttar Pradesh, India, The Evidence Project
Utilization Of National Health Insurance For Family Planning And Reproductive Health Services By The Urban Poor In Uttar Pradesh, India, The Evidence Project
Reproductive Health
In 2008, the Government of India launched the National Health Insurance program, Rashtriya Swasthya Bima Yojana (RSBY), to enable families living below the poverty line in urban and rural areas to access a range of private health services. Enrolled families can access packages of services from RSBY-participating private hospitals, including family planning (FP) and other reproductive health (RH) services. Despite the availability of insurance coverage, poor families’ utilization of RSBY for FP/RH services is believed to be negligible. The Evidence Project is conducting a study in three cities in Uttar Pradesh to better understand the factors affecting utilization of RSBY …
The Impact Of Population, Health, And Environment Projects: A Synthesis Of Evidence, Rachel Winnik Yavinsky, Carolyn Lamere, Kristen P. Patterson, Jason Bremner
The Impact Of Population, Health, And Environment Projects: A Synthesis Of Evidence, Rachel Winnik Yavinsky, Carolyn Lamere, Kristen P. Patterson, Jason Bremner
Reproductive Health
This working paper synthesizes the existing research and results from projects that integrate family planning with environment, livelihoods, natural-resource management, and other non-health development sectors. The report synthesizes the published and gray literature on current and past integrated projects and the experiences of implementers to generate a summary of the state of knowledge on integrated family planning and environment projects. Specifically, this synthesis documents what is being measured by integrated projects, the proven benefits of integration, and gaps in the evidence base. Based on this analysis, the synthesis highlights and discusses successes and challenges for documenting the impact of integrating …
Standard Days Method Of Contraception: Evidence On Use, Implementation, And Scale Up, Kelsey Wright, Hiba Iqteit, Karen Hardee
Standard Days Method Of Contraception: Evidence On Use, Implementation, And Scale Up, Kelsey Wright, Hiba Iqteit, Karen Hardee
Reproductive Health
In 2002, an article in Contraception reported on a trial for a new method of contraception, the Standard Days Method (SDM). SDM is a fertility awareness-based family planning (FP) method that identifies the eighth through nineteenth days of a woman’s menstrual cycle as the fertile window. SDM users abstain or use barrier methods during their fertile periods to prevent pregnancy. The trial established a first-year method failure rate of 5 per 100 woman years with correct use, and 12 per 100 women for typical use. Over the decade since the publication of the original efficacy trial, the Georgetown University Institute …
Progesterone Vaginal Ring: Results Of A Three-Country Acceptability Study, Saumya Ramarao, Heather Clark, Deepa Rajamani, Salisu Mohammed Ishaku, Babacar Mane, Francis Obare, Harriet Birungi, Nafissatou Diop, Wilson Liambila, Fatou Mbow, Chi-Chi Undie, Godwin Unumeri, John Townsend
Progesterone Vaginal Ring: Results Of A Three-Country Acceptability Study, Saumya Ramarao, Heather Clark, Deepa Rajamani, Salisu Mohammed Ishaku, Babacar Mane, Francis Obare, Harriet Birungi, Nafissatou Diop, Wilson Liambila, Fatou Mbow, Chi-Chi Undie, Godwin Unumeri, John Townsend
Reproductive Health
Global and national policies have refocused attention on postpartum family planning as an important component of ensuring healthy outcomes for women and babies. The progesterone vaginal ring (PVR) is used to extend the contraceptive effectiveness of lactational amenorrhea among breastfeeding women. Clinical trials have proven the PVR to be safe and effective; it is currently registered in eight Latin American countries. There is a need to assess acceptability prior to introduction into country programs, and the Population Council conducted PVR acceptability studies in Kenya, Nigeria, and Senegal. This report represents the results from a pooled analysis of data from the …
Progesterone Vaginal Ring: Results Of An Acceptability Study In Nigeria, Salisu Mohammed Ishaku, Afolabi Kayode, Godwin Unumeri, Ayodeji Oginni, Adekunle Adeyemi, Deepa Rajamani, Heather Clark, Naomi Rijo, Saumya Ramarao
Progesterone Vaginal Ring: Results Of An Acceptability Study In Nigeria, Salisu Mohammed Ishaku, Afolabi Kayode, Godwin Unumeri, Ayodeji Oginni, Adekunle Adeyemi, Deepa Rajamani, Heather Clark, Naomi Rijo, Saumya Ramarao
Reproductive Health
The progesterone vaginal ring (PVR) is used to extend the contraceptive effectiveness of lactational amenorrhea among breastfeeding women. The PVR was first registered in Chile and Peru in 1998 for use by postpartum women and has since been expanded to other Latin American countries. Previous studies have shown that contraceptive vaginal rings are safe, effective, and well accepted in varied cultural settings. However, the extent to which the ring is acceptable in the sub-Saharan African context is unknown. This study examined the acceptability of the PVR in Nigeria as part of a larger project that was also conducted in Kenya …
Progesterone Vaginal Ring: Beneficial Role In Birth Spacing, Population Council
Progesterone Vaginal Ring: Beneficial Role In Birth Spacing, Population Council
Reproductive Health
As a result of growing urbanization and changing social norms concerning the role of women in developing countries, the duration of exclusive breastfeeding and its impact as a contraceptive strategy has been reduced. This has given rise to the need for a contraceptive method that can extend the infertile period following delivery, especially in countries where access to other contraceptives is limited and where longer duration of breastfeeding is a social norm and a major benefit to infant health. This project brief provides information on the progesterone vaginal ring (PVR), which can enhance the effect of breastfeeding on birth spacing. …
Reasons For Low Modern Contraceptive Use—Insights From Pakistan And Neighboring Countries, Batool Zaidi, Sabahat Hussain
Reasons For Low Modern Contraceptive Use—Insights From Pakistan And Neighboring Countries, Batool Zaidi, Sabahat Hussain
Reproductive Health
This literature review forms part of an extensive research project to determine why, despite evident demand, contraceptive prevalence remains so low in Pakistan, especially for modern methods. The research has been conducted by the Population Council with the support of the Research and Advocacy Fund (RAF) and comprises four component studies: review of relevant academic, program, and policy literature; qualitative study of perspectives of men, women, and service providers in the country on family planning; situation analysis of contraceptive quality, supply, and access factors at health facilities; and examination of supply-chain issues affecting the availability of contraceptives. This review presents …
Peer Mentoring: An Effective Strategy For Integrating Hiv And Srh Services, Integra Initiative
Peer Mentoring: An Effective Strategy For Integrating Hiv And Srh Services, Integra Initiative
Reproductive Health
Mentoring is an innovative approach to improving provider skills without compromising service delivery by harnessing the potential of existing providers. In Kenya, a peer-mentorship approach was designed and tested to improve service providers’ skills, knowledge, and capacity to provide high-quality integrated HIV and SRH services. A central component was to understand providers’ opinions on mentoring, so as to build a practical and sustainable mentorship model. The “Steps to Integration” series provides a guide on how to integrate HIV and SRH services based on findings from the Integra Initiative, managed by the International Planned Parenthood Federation in partnership with the London …
Srh And Hiv Service Integration And Stigma, Integra Initiative
Srh And Hiv Service Integration And Stigma, Integra Initiative
Reproductive Health
Stigma is frequently faced by people living with HIV and those who they are associated with, and is frequently followed by discrimination. The “Steps to Integration” series provides a guide on how to integrate HIV and SRH services based on findings from the Integra Initiative, managed by the International Planned Parenthood Federation in partnership with the London School of Hygiene & Tropical Medicine and the Population Council. Issue 3 of the series explores the experience of stigma among clients living with HIV in a variety of settings, both service-based (when seeking family planning, antenatal, and postnatal care services) and facility-based …
Health Facility Guidelines And Management Benchmarks: Improving Workplace Health Services And Health Management In Factories, Farms And Other Workplaces In Low- And Middle-Income Countries, David Wofford, Marat Yu, Lauren Shields, Maria Pontes
Health Facility Guidelines And Management Benchmarks: Improving Workplace Health Services And Health Management In Factories, Farms And Other Workplaces In Low- And Middle-Income Countries, David Wofford, Marat Yu, Lauren Shields, Maria Pontes
Reproductive Health
This document contains a set of voluntary health and management guidelines for corporations and their supply chains to promote continual improvement and application of good practices, better access to men’s and women’s health services, and more effective use of health resources at workplaces in the developing world. It is focused on both quality of health services provided at the workplace and adequacy of company policies and management systems to ensure that workers have access to health services. The main goals of the guidelines are to: 1) help enterprises—multinational companies and their supplier or subsidiary companies in developing countries—improve the management …
Participatory Research Results From Training With The Mabinti Tushike Hatamu Out-Of-School Girls Program: Tanzania 2015, Kelly Hallman, Ilan Cerna-Turoff, Neema Matee
Participatory Research Results From Training With The Mabinti Tushike Hatamu Out-Of-School Girls Program: Tanzania 2015, Kelly Hallman, Ilan Cerna-Turoff, Neema Matee
Poverty, Gender, and Youth
The Mabinti Tushike Hatamu (Girls let’s be leaders!) program is designed to test and evaluate strategies for reducing the vulnerability of out-of-school adolescent girls in Tanzania aged 10–19 years to HIV/AIDS, pregnancy, and unfavorable life outcomes. MTH is led by the Tanzania AIDS Commission, implemented by Restless Development, and supported by UNICEF. The Population Council developed a strategy for Restless Development to capture the richness of its activities. The Council designed a training session and a companion toolkit in participatory action research for community volunteers, aged 19–23 years, to use within their girl groups. This report describes the findings from …
Africa’S Slow Fertility Transition, John Bongaarts
Africa’S Slow Fertility Transition, John Bongaarts
Poverty, Gender, and Youth
No abstract provided.
Adolescent Girls Empowerment Program (Agep): Program Overview, Population Council
Adolescent Girls Empowerment Program (Agep): Program Overview, Population Council
Poverty, Gender, and Youth
For Zambian girls, social isolation, economic vulnerability, and lack of appropriate health information and services are critical problems that prevent a healthy transition from girlhood to womanhood. The challenges that girls are confronted with—high rates of gender-based violence, unsafe sex that puts girls at risk for unwanted pregnancy and HIV infection, school dropout, lack of economic resources and income-generating options, lack of agency and participation—are linked together through their root causes. Therefore, the solutions must be interconnected as well. Through the Adolescent Girls Empowerment Program (AGEP), the Population Council and partners are implementing a social, health, and economic asset-building program …
Adolescent Girls Initiative-Kenya: Program Overview, Population Council
Adolescent Girls Initiative-Kenya: Program Overview, Population Council
Poverty, Gender, and Youth
Many adolescent girls in Kenya face considerable risks and vulnerabilities that affect their education, health, and general well-being—including early marriage; teenage pregnancy; early, unprotected, and/or unwanted sexual activity; violence; social isolation; and HIV/STIs. For the most part, very young adolescent girls who live in risk-prone environments have not yet experienced these negative outcomes. It is critical, therefore, to intervene early and increase girls’ capacity to overcome these risks before the challenges result in outcomes that may be irreversible. Research has shown that single-sector interventions are not adequate to obtain the range of outcomes needed to help girls enter into adulthood …
Sexual And Gender-Based Violence: Baseline Findings, Population Council
Sexual And Gender-Based Violence: Baseline Findings, Population Council
Poverty, Gender, and Youth
The Adolescent Girls Empowerment Program (AGEP) is a program for girls ages 10-19 in rural and urban Zambia that aims to find the best ways to improve their social, health, and economic resources. Sexual and gender-based violence (SGBV) is a pervasive global health problem. Women and girls are most at risk, and consequences include physical injury, psychological trauma, unwanted pregnancy, and sexually transmitted infections, including HIV. The AGEP program involves over 10,000 girls participating in weekly girls’ group meetings, receiving health vouchers and opening savings accounts. Over 5,000 girls, unmarried at baseline, are enrolled in a randomized, controlled trial and …
Urban Adolescents Needs Assessment Survey In Bangladesh, Sajeda Amin
Urban Adolescents Needs Assessment Survey In Bangladesh, Sajeda Amin
Poverty, Gender, and Youth
This report presents data on multiple dimensions of adolescents’ lives in urban settlements in Dhaka and Gazipur districts, Bangladesh. The study provides evidence on the lives of young people in a manner that can inform programs and policies directed toward this underserved population. Data is presented on education; reproductive health; family planning; marriage and dowry; physical mobility and social context; gender equality; family life, relationships, and emotional well-being; substance abuse; and livelihoods. There is presently little information about what makes adolescent girls and boys vulnerable in urban settings. The analysis explores and highlights sex, age, education, and marital-status-related differentials among …
Evidence Of Son Preference And Resulting Demographic And Health Outcomes In Pakistan, Zeba Sathar, Gul Rashida, Sabahat Hussain, Anushe Hassan
Evidence Of Son Preference And Resulting Demographic And Health Outcomes In Pakistan, Zeba Sathar, Gul Rashida, Sabahat Hussain, Anushe Hassan
Poverty, Gender, and Youth
Pakistan has a highly patriarchal society. Consequently, the desire for sons is a dominant and widely prevalent cultural value that is reinforced by feudal kinship systems that permeate many parts of the country. While reliance on sons is stronger in rural areas because of agricultural work and the tying of land ownership with male inheritance, even in other areas boys are seen to be important in carrying on the family name and taking care of parents in old age. On the other hand, daughters are seen as an expense and an economic burden in both rural and urban areas. A …
Gender-Biased Sex Selection In India: A Review Of The Situation And Interventions To Counter The Practice, Shireen J. Jejeebhoy, Sharmistha Basu, Rajib Acharya, A.J. Francis Zavier
Gender-Biased Sex Selection In India: A Review Of The Situation And Interventions To Counter The Practice, Shireen J. Jejeebhoy, Sharmistha Basu, Rajib Acharya, A.J. Francis Zavier
Poverty, Gender, and Youth
This report on gender-biased sex selection in India is divided into six chapters, including an introduction in Chapter 1. Chapter 2 describes the laws and policies adopted by India to address gender-biased sex selection, as well as those intended to support and empower women and girls. Chapter 3 analyzes the trends and geographic variation in the sex ratio at birth and in the child sex ratio. Chapter 4 briefly describes the socioeconomic differences and factors underlying distorted sex ratios and gender-biased sex selection in India, and the social consequences of these practices. Experiences in implementing the PCPNDT Act, initiatives intended …