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Development Of Dose Coefficients For Radionuclides Produced In Spallation Targets, Phillip W. Patton, Mark Rudin
Development Of Dose Coefficients For Radionuclides Produced In Spallation Targets, Phillip W. Patton, Mark Rudin
Transmutation Sciences Physics (TRP)
Dose coefficients permit simple determination of radiation dose associated with various exposure scenarios, and ultimately permit radiation safety personnel to assess the health risks to workers in a nuclear facility. Specifically, radiation safety personnel use dose coefficients to determine the radiation dose incurred to a tissue or organ system from a given exposure. These parameters are often expressed in terms of Annual Limits on Intake (ALIs) and Derived Air Concentrations (DACs).
Results from this study will be used to produce ALIs and DACs for these rare radionuclides created by spallation target systems that are not included in Federal Guidance Report …
Development Of Dose Coefficients For Radionulides Produced In Spallation Neutron Sources: Annual Report, Phillip W. Patton, Mark Rudin
Development Of Dose Coefficients For Radionulides Produced In Spallation Neutron Sources: Annual Report, Phillip W. Patton, Mark Rudin
Transmutation Sciences Physics (TRP)
The University of Nevada, Las Vegas (UNLV) Transmutation Research Program has been tasked to support U.S. Department of Energy (DOE) efforts to assess the health risks associated with the operation of each of their accelerator-driven nuclear facilities for both NEPA and PSAR development. Quantifying the radiological risks to workers will have to be addressed during the design and siting of each of these facilities. U.S. Environmental Protection Agency (EPA) Federal Guidance Report No. 11 “Limiting Values of Intake and Air Concentration and Dose Conversion Factors for Inhalation, Submersion, and Ingestion”, developed two derived guides, Annual Limit on Intake (ALI) and …
Evidence-Based Development Of Health And Family Planning Programs In Bangladesh And Ghana, James F. Phillips, Tanya C. Jones, Frank K. Nyonator, Shruti Ravikumar
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 …
Determinants Of Old-Age Mortality In Taiwan, Zachary Zimmer, Linda G. Martin, Hui-Sheng Lin
Determinants Of Old-Age Mortality In Taiwan, Zachary Zimmer, Linda G. Martin, Hui-Sheng Lin
Poverty, Gender, and Youth
Relationships among socio-demographic characteristics, general assessments of health, and old-age mortality are well established in developed countries. There is also an increasing focus on the connection between early-life experiences and latelife health. This paper tests these and other associations using representative survey data from Taiwan on the population aged 60 and older in 1989, 1993, and 1996 that have been linked to data on deaths between 1989 and 1999 from a national death registry. The study also explores the possible influence of Taiwan’s Universal Health Insurance Program, instituted in 1995, and whether or not the survival of some groups of …
Estimating Mean Lifetime, John Bongaarts, Griffith Feeney
Estimating Mean Lifetime, John Bongaarts, Griffith Feeney
Poverty, Gender, and Youth
The life expectancy implied by current age-specific mortality rates is calculated with life table methods that are among the oldest and most fundamental tools of demography. We demonstrate that these conventional estimates of period life expectancy are affected by an undesirable “tempo effect.” The tempo effect is positive when the mean age at death is rising and negative when the mean age is declining. Estimates of the effect for females in three countries with high and rising life expectancy range from 1.6 years in the United States and Sweden to 2.4 years in France for the period 1980-95.
Completing The Fertility Transition In The Developing World: The Role Of Educational Differences And Fertility Preferences, John Bongaarts
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 …
The Ghana Community-Based Health Planning And Services Initiative: Fostering Evidence-Based Organizational Change And Development In A Resource-Constrained Setting, Frank K. Nyonator, John Koku Awoonor-Williams, James F. Phillips, Tanya C. Jones, Robert A. Miller
The Ghana Community-Based Health Planning And Services Initiative: Fostering Evidence-Based Organizational Change And Development In A Resource-Constrained Setting, Frank K. Nyonator, John Koku Awoonor-Williams, James F. Phillips, Tanya C. Jones, Robert A. Miller
Poverty, Gender, and Youth
Research projects demonstrating ways to improve health services often fail to have an impact on what national health programs actually do. An approach to evidence-based policy development has been launched in Ghana that bridges the gap between research and program implementation. The Community-based Health Planning and Services (CHPS) initiative employs strategies tested in the successful Navrongo experiment to guide national health reforms that mobilize volunteers, resources, and cultural institutions to support community-based primary health care. Over the 1999 to 2002 period, 100 out of the 110 districts in Ghana adopted a CHPS initiative. This paper reviews features of the initiative …
Primary Schooling In Sub-Saharan Africa: Recent Trends And Current Challenges, Cynthia B. Lloyd, Paul C. Hewett
Primary Schooling In Sub-Saharan Africa: Recent Trends And Current Challenges, Cynthia B. Lloyd, Paul C. Hewett
Poverty, Gender, and Youth
At the dawn of the twenty-first century we estimate that more than 37 million young adolescents aged 10-14 in sub-Saharan Africa will not complete primary school. Our estimates are based on data from nationally representative Demographic and Health Surveys from 26 countries, collectively representing 83 percent of the sub-Saharan youth population. This number is nearly twice the entire population of children aged 10-14 in the United States, virtually all of whom will complete primary school. Reducing the number of uneducated African youth is a primary objective of the United Nations as laid out in the Millennium Development Goal for education, …
The Feasibility Of Computer-Assisted Survey Interviewing In Africa: Experience From Two Rural Districts In Kenya, Paul C. Hewett, Annabel Erulkar, Barbara Mensch
The Feasibility Of Computer-Assisted Survey Interviewing In Africa: Experience From Two Rural Districts In Kenya, Paul C. Hewett, Annabel Erulkar, Barbara Mensch
Poverty, Gender, and Youth
This paper explores the use of an audio computer-assisted self-interviewing (audio-CASI) methodology in a household survey of adolescents in two districts of Kenya. Computer software was developed as part of a research project comparing audio-CASI with traditional methods of interviewing about sensitive behaviors, including sexual initiation, risky sexual behavior, coerced sex, and drug and alcohol use. The paper describes the experience of carrying out a household-based study using computers and explores the technical challenges faced by the data collection teams. Few problems emerged with the computer hardware and software, despite the difficult interviewing conditions. The adolescent respondents easily adapted to …
Condom Use And Abstinence Among Unmarried Young People In Zimbabwe: Which Strategy, Whose Agenda?, Ravai Marindo, Steve Pearson, John B. Casterline
Condom Use And Abstinence Among Unmarried Young People In Zimbabwe: Which Strategy, Whose Agenda?, Ravai Marindo, Steve Pearson, John B. Casterline
Poverty, Gender, and Youth
This paper compares the views about abstinence and condom use expressed by young people in Zimbabwe in focus-group discussions with the views underlying national policies and religious and traditional beliefs. Young people’s decisions to adopt one or the other of these risk-reduction strategies may not necessarily indicate genuine individual choices, but rather their deference to adults’ interests as they understand those interests. Policymakers and traditional and Christian leaders promote abstinence as the exclusive strategy for all young people, whereas nongovernmental organizations and the private sector promote condom use. Evidence from the focus-group discussions indicates that adolescents are aware of this …
Population And Development: An Introductory View, Geoffrey Mcnicoll
Population And Development: An Introductory View, Geoffrey Mcnicoll
Poverty, Gender, and Youth
A brief overview of the relationships between population change and economic development, written for readers unfamiliar with the subject. The paper touches on the scale and pace of world development, the economic consequences of population size and rate of growth, patterns of demographic transition, and the scope for policy measures aimed at speeding that transition.
Legal Movements In Intellectual Property: Trips, Unilateral Action, Bilateral Agreements, And Hiv/Aids, Margo A. Bagley
Legal Movements In Intellectual Property: Trips, Unilateral Action, Bilateral Agreements, And Hiv/Aids, Margo A. Bagley
Faculty Articles
This Article begins with an overview of the relationship between the Agreement on Trade-Related Aspects of Intellectual Property Rights (the "TRIPS Agreement") and the HIV/AIDS pandemic which created the need for the Doha Declaration. It then discusses two trade-related movements, unilateral action and TRIPS-plus bilateral agreements, that call into question the long-term effectiveness of the TRIPS Agreement process, generally, and the benefits of the Doha Declaration, in particular, in addressing multiple facets of the access to essential medicines problem. This Article concludes that a consideration of these issues should be included in the development of any further TRIPS-related solutions to …
Troubles Musculo-Squelettiques Et Bureautique : Impact Du Mobilier De Bureau Sur La Posture Et La Sollicitation Musculaire Du Membre Supérieur, Alain Delisle, Christian Larivière, André Plamondon, Daniel Imbeau
Troubles Musculo-Squelettiques Et Bureautique : Impact Du Mobilier De Bureau Sur La Posture Et La Sollicitation Musculaire Du Membre Supérieur, Alain Delisle, Christian Larivière, André Plamondon, Daniel Imbeau
Rapports de recherche scientifique
Click here for the English version of this report
La présente étude avait pour objectif de déterminer si l'utilisation d'un mobilier de bureau ajustable en hauteur offrant un appui au niveau des avant-bras sur la surface de travail permet de réduire la sollicitation musculaire tout en minimisant l’impact sur la posture du membre supérieur. Dix-huit sujets ont effectué une tâche de travail à l’ordinateur de 20 minutes impliquant du travail alterné entre le clavier et la souris, avec trois mobiliers de bureau différents : un mobilier à surface unique avec support-écran indépendant, entièrement ajustable en hauteur, permettant l'appui des avant-bras …
Wage Work And Marriage: Perspectives Of Egyptian Working Women, Sajeda Amin, Nagah Hassan Al Bassusi
Wage Work And Marriage: Perspectives Of Egyptian Working Women, Sajeda Amin, Nagah Hassan Al Bassusi
Poverty, Gender, and Youth
This paper explores young working women’s perceptions of marriage and work in contemporary Egypt at a time when an increase in age at marriage was evident from national survey data. Data from two nationally representative labor surveys, the Labor Force Sample Survey of 1988 and the Egypt Labor Market Survey of 1998, show that working conditions and employment opportunities declined significantly for young women even as their educational attainment increased. Indepth interviews were conducted with young women working in a range of salaried jobs in three locations: a rural village in Mansoura, a periurban district near Cairo, and in the …
Adolescents And Youth In Pakistan 2001-2002: A Nationally Representative Survey, Zeba Sathar, Minhaj Ul Haque, Azeema Faizunnissa, Munawar Sultana, Cynthia B. Lloyd, Judith A. Diers, Monica J. Grant
Adolescents And Youth In Pakistan 2001-2002: A Nationally Representative Survey, Zeba Sathar, Minhaj Ul Haque, Azeema Faizunnissa, Munawar Sultana, Cynthia B. Lloyd, Judith A. Diers, Monica J. Grant
Poverty, Gender, and Youth
Published by the Population Council's Islamabad office, this is the first comprehensive survey of Pakistani youth. The report provides an unprecedented view of young people's experiences with and attitudes about education, employment, families, and marriage. The report findings confirm the large differences in the current situation of adolescents and youth, males versus females, from different strata of residence and economic status. Addressing these requires government intervention, changes in attitude, and input from the media, women and youth groups, and members of civil society.
My Father Didn't Think This Way': Nigerian Boys Contemplate Gender Equality, Françoise Girard
My Father Didn't Think This Way': Nigerian Boys Contemplate Gender Equality, Françoise Girard
Poverty, Gender, and Youth
One of the lessons emerging from adolescent programs around the world is the need to create settings where young men can question things that are often seen as unquestionable, such as what it means to be a man. This issue explores the Conscientizing Male Adolescents (CMA) program in Nigeria which, unlike many programs targeting adolescent boys that emphasize short-term activities aimed at preventing disease and unwanted pregnancy, is a long-term program focusing on sexism and critical-thinking skills. An initial evaluation indicates that such programs affirm that we do know how to engage young men, and that historically reinforced gender attitudes …
« Mon Père Pensait Autrement » : Des Garçons Nigérians Réfléchissent À L'Égalité Entre Les Sexes, Françoise Girard
« Mon Père Pensait Autrement » : Des Garçons Nigérians Réfléchissent À L'Égalité Entre Les Sexes, Françoise Girard
Poverty, Gender, and Youth
L’une des leçons émergeant des programmes pour adolescents dans le monde entier concerne la nécessité de créer des cadres où les jeunes hommes peuvent remettre en question ce qui est souvent considéré comme incontestable, par exemple ce que signifie « être un homme ». Ce numéro décrit le programme nigérian « Conscientiser les adolescents de sexe masculin » (CMA, Conscientizing Male Adolescents). Contrairement à beaucoup de programmes visant les adolescents de sexe masculin, qui mettent l’accent sur des activités à court terme destinées à prévenir la maladie et les grossesses non désirées, le modèle proposé par CMA est un programme …
The Living Arrangements Of Older Adults In Sub-Saharan Africa In A Time Of Hiv/Aids, Zachary Zimmer, Julia Dayton
The Living Arrangements Of Older Adults In Sub-Saharan Africa In A Time Of Hiv/Aids, Zachary Zimmer, Julia Dayton
Poverty, Gender, and Youth
The detrimental consequences of the AIDS epidemic for older adults in sub-Saharan Africa suggest the need to investigate their characteristics, living situations, and well-being. In this study, we examine the living arrangements of persons aged 60 and older in 16 countries. Data come from the household roster component of recent Demographic and Health Surveys. The focus is on the tendency of the elderly to live with children and grandchildren, and we examine distributions and determinants. Results show that older adults in sub-Saharan Africa live in a variety of household arrangements. Men are more likely to be living in a nuclear …
How Indicators Of Socioeconomic Status Relate To Physical Functioning Of Older Adults In Three Asian Societies, Zachary Zimmer, Napaporn Chayovan, Hui-Sheng Lin, Josefina N. Natividad
How Indicators Of Socioeconomic Status Relate To Physical Functioning Of Older Adults In Three Asian Societies, Zachary Zimmer, Napaporn Chayovan, Hui-Sheng Lin, Josefina N. Natividad
Poverty, Gender, and Youth
In developed countries, socioeconomic status has been identified as one of the most important demographic and social determinants of older adult health. The relationship has not been well studied or contrasted across much of the developing world. Yet, with population aging occurring rapidly in much of Asia, understanding the factors that distinguish between those in better and worse health becomes important. To this end, the current study has two main aims. It first examines the degree to which two measures commonly used to indicate socioeconomic status, education and income, relate to the physical functioning of older adults in three Asian …
Population Policy: A Concise Summary, Paul Demeny
Population Policy: A Concise Summary, Paul Demeny
Poverty, Gender, and Youth
Population policies are deliberately constructed or modified institutional arrangements and/or specific programs through which governments influence, directly or indirectly, demographic change. For any given country, the aim of population policy may be narrowly construed as bringing about quantitative changes in the membership of the territorially circumscribed population under the government’s jurisdiction. Governments’ concern with population matters can also extend beyond the borders of their own jurisdictions. Thus, international aspects of population policy have become increasingly salient in the contemporary world. Additions to the population are primarily the result of individual decisions concerning childbearing. Within the constraints of their social milieu, …
Marriage In Transition: Evidence On Age, Education, And Assets From Six Developing Countries, Agnes R. Quisumbing, Kelly Hallman
Marriage In Transition: Evidence On Age, Education, And Assets From Six Developing Countries, Agnes R. Quisumbing, Kelly Hallman
Poverty, Gender, and Youth
Marriage is an event of great social and economic significance in most societies. Despite the centrality of marriage in an individual’s life history, the literature on marriage patterns pays little attention to men. This paper examines trends in schooling, age, and assets at marriage for both men and women, and spousal differences in these variables in six countries-Bangladesh, Ethiopia, Guatemala, Mexico, the Philippines, and South Africa-using comparable data sets and methodologies.
Consistency In The Reporting Of Sexual Behavior Among Adolescent Girls In Kenya: A Comparison Of Interviewing Methods, Paul C. Hewett, Barbara Mensch, Annabel Erulkar
Consistency In The Reporting Of Sexual Behavior Among Adolescent Girls In Kenya: A Comparison Of Interviewing Methods, Paul C. Hewett, Barbara Mensch, Annabel Erulkar
Poverty, Gender, and Youth
This paper explores the consistency in reporting of sexual behavior in a household survey of adolescents aged 15-21 in the Kisumu district of Kenya. Respondents were randomly assigned to different interviewing modes: face-to-face interviews, paper-and-pencil self-administered interviews, and audio computer-assisted self-interviewing (ACASI). The analysis focuses on the reporting of sexual behavior by adolescent girls in the face-to-face and ACASI modes and compares responses to a variety of questions about sexual activity, including sexual initiation, risky sexual behavior, and coerced sex. All sexual behavior questions were asked of each adolescent girl even if she answered “no” to the initial question about …
Women's Denial Of Having Experienced Female Genital Cutting In Northern Ghana: Explanatory Factors And Consequences For Analysis Of Survey Data, Elizabeth F. Jackson, Patricia Akweongo, Evelyn Sakeah, Abraham Hodgson, Rofina Asuru, James F. Phillips
Women's Denial Of Having Experienced Female Genital Cutting In Northern Ghana: Explanatory Factors And Consequences For Analysis Of Survey Data, Elizabeth F. Jackson, Patricia Akweongo, Evelyn Sakeah, Abraham Hodgson, Rofina Asuru, James F. Phillips
Poverty, Gender, and Youth
Although many cross-sectional social surveys have included questions about female genital cutting status and correlated personal characteristics, no longitudinal studies have been launched that permit investigation of response biases associated with such surveys. This paper reports on a longitudinal study of women aged 15 to 49 in rural northern Ghana. The self-reported circumcision status of women interviewed in 1995 was compared with the status they reported when they were interviewed again in 2000 after the government began enforcing a law banning the practice and public information campaigns against it were launched. In all, 13 percent of respondents who reported in …
Evaluating Operations Research Utilization: Guidelines For Assessing Process And Impact, M. Celeste Marin, Jane T. Bertrand
Evaluating Operations Research Utilization: Guidelines For Assessing Process And Impact, M. Celeste Marin, Jane T. Bertrand
Reproductive Health
The Population Council has been providing technical assistance and conducting Operations Research (OR) studies in family planning and reproductive health for over two decades. These studies are designed to identify problems and test strategies to resolve those problems, providing program managers, administrators, and policymakers with the information they need to improve service-delivery systems. The ultimate goal is that strategies tested through OR will be adopted, leading to changes in policy or operational procedures at institutional, national, or international levels. These changes are what we refer to as impact. The purpose of the new approach to evaluation described in this Evaluation …
The Impact Of Quality Of Care On Contraceptive Use: Evidence From Longitudinal Data From Rural Bangladesh, Michael A. Koenig
The Impact Of Quality Of Care On Contraceptive Use: Evidence From Longitudinal Data From Rural Bangladesh, Michael A. Koenig
Reproductive Health
This project provides convincing empirical evidence on the impact of quality of care on contraceptive use and fertility behavior through analysis of a unique longitudinal data set from rural Bangladesh. The findings from this project add important new and methodologically rigorous evidence to the emerging literature on the implications of service quality on contraceptive behavior. The results reaffirm the importance of female fieldworker outreach—both in terms of quality and the number of visits—on contraceptive use dynamics in rural Bangladesh. In addition to these substantive findings, the study makes important methodological contributions in assessing the impact of programmatic variables—especially quality of …
Testing A Model For The Delivery Of Emergency Obstetric Care And Family Planning Services In The Bolivian Public Health System, Deborah L. Billings, Eliana Del Pozo, Hugo Arevalo
Testing A Model For The Delivery Of Emergency Obstetric Care And Family Planning Services In The Bolivian Public Health System, Deborah L. Billings, Eliana Del Pozo, Hugo Arevalo
Reproductive Health
Unsafe abortion is a serious public health problem in Bolivia, accounting for up to 25 percent of maternal mortality. Postabortion care (PAC) was recognized as a priority public health action in Bolivia in 1994 and the operations research project summarized in this report was undertaken at the request of the Ministry of Health to help guide the improvement of PAC services in the country’s revised health plan. Improvements were made in the following areas: informing women of their health status after the uterine evacuation procedure; elements of the procedure itself (instrument to be used, pain control, possible risks); and informing …
An Assessment Of Trends In The Use Of The Iud In Ghana, John Gyapong, Gifty Addico, Ivy Osei, Mercy Abbey, Dominic Atweam Kobinah, Henrietta Odoi-Agyarko, Gloria Quansah Asare, Harriet Birungi, Ian Askew
An Assessment Of Trends In The Use Of The Iud In Ghana, John Gyapong, Gifty Addico, Ivy Osei, Mercy Abbey, Dominic Atweam Kobinah, Henrietta Odoi-Agyarko, Gloria Quansah Asare, Harriet Birungi, Ian Askew
Reproductive Health
Use of the IUD in relation to other contraceptive methods is reported to have either stagnated or declined in a number of countries including Ghana. The overall aim of this study was to inform the Ghana Health Service, USAID, and other partners on future directions for contraceptive promotion and supply. The stagnating demand for the IUD as a family planning method can be attributed to several factors, including perceptions and rumors about the method. The study recommends: intensified marketing of the IUD through the Ghana Life Choices Program; IUD-focused training and creation of a critical mass of trained IUD providers; …
Testing Balanced Counseling To Improve Provider-Client Interaction In Guatemala's Moh Clinics, Federico R. Leon, Carlos Brambila, Marisela De La Cruz, John H. Bratt, Julio Garcia Colindres, Benedicto Vasquez, Carlos Morales
Testing Balanced Counseling To Improve Provider-Client Interaction In Guatemala's Moh Clinics, Federico R. Leon, Carlos Brambila, Marisela De La Cruz, John H. Bratt, Julio Garcia Colindres, Benedicto Vasquez, Carlos Morales
Reproductive Health
The job aids–assisted Balanced Counseling Strategy adopted by Guatemala’s Ministry of Health required specific instructions for use by nonprofessional providers and an intervention that assured provider compliance with the behavioral requirements of the new paradigm. Results show that the trained providers outperformed the controls in quality of care at each level of session length, but used nine extra minutes per session on average. Nonprofessional providers can take advantage of the job aids–assisted Balanced Counseling Algorithm and substantially improve their quality of care. Extra time invested in counseling new family planning clients will be easily absorbed insofar as they continue to …
Availability And Acceptability Of Iuds In Guatemala, Carlos Brambila, Berta Taracena
Availability And Acceptability Of Iuds In Guatemala, Carlos Brambila, Berta Taracena
Reproductive Health
The purpose of this study was to identify the reasons for the low use of the IUD in Guatemala and to explore the reasons why other reversible methods are selected more frequently than IUDs. The study aimed to determine the availability and acceptability of IUDs as a contraceptive option within the Ministry of Health, the Guatemalan Social Security Institute, and APROFAM. Results indicated that service providers do not take into consideration women’s reproductive needs or intentions when they provide family planning counseling. There are several demand-side factors that affect the use of the IUD, including lack of knowledge about the …
One-Year Client Impacts Of Quality Of Care Improvements Achieved In Peru, Federico R. Leon, Santiago Roca, Alex Rios, Adriana Zumaran, Ana Rosa Feijoo
One-Year Client Impacts Of Quality Of Care Improvements Achieved In Peru, Federico R. Leon, Santiago Roca, Alex Rios, Adriana Zumaran, Ana Rosa Feijoo
Reproductive Health
This report presents a one-year assessment of quality-of-care improvements in Peru, following provider training on the job aids–assisted Balanced Counseling Strategy. Results showed significant enhancement of quality of care, an increase in session length, and improved client knowledge of the method chosen when this was an IUD or hormonal method. Correlational findings suggested that better impacts can be achieved in provincial primary health facilities than in larger settings like clinics or hospitals in capital cities. The results are important because: 1) other studies have failed to show significant impacts of controlled quality-of-care improvements on the use of contraception; and 2) …