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Full-Text Articles in International Public Health
Demand For And Access To Family Planning Services Among Young Married Women During Covid-19 Crisis, Unicef, Population Council Institute
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
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
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
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 …
Accelerating Reproductive And Child Health Program Development: The Navrongo Initiative In Ghana, James F. Phillips, Ayaga A. Bawah, Fred N. Binka
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
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 …
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 …
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 …
Completing The Fertility Transition In The Developing World: The Role Of Educational Differences And Fertility Preferences [Arabic], John Bongaarts
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 …
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 …
The End Of The Fertility Transition In The Developed World, John Bongaarts
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
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
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
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 …
Adolescent Pregnancy And Parenthood In South Africa, Carol E. Kaufman, Thea De Wet, Jonathan Stadler
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 …
Unmet Need For Family Planning In Developing Countries And Implications For Population Policy [Arabic], John B. Casterline, Steven W. Sinding
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
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 …
Completing The Demographic Transition, John Bongaarts, Rodolfo A. Bulatao
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
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 …
Population Weights In The International Order, Geoffrey Mcnicoll
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 Fertility Impact Of Changes In The Timing Of Childbearing In The Developing World, John Bongaarts
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 …
Fertility Preferences And Contraceptive Change In Developing Countries, Bamikale J. Feyisetan, John B. Casterline
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 …
Women's Lives And Rapid Fertility Decline: Some Lessons From Bangladesh And Egypt, Sajeda Amin, Cynthia B. Lloyd
Women's Lives And Rapid Fertility Decline: Some Lessons From Bangladesh And Egypt, Sajeda Amin, Cynthia B. Lloyd
Poverty, Gender, and Youth
In some of the more traditional parts of the world, fertility is falling steadily, sometimes rapidly, in environments where women’s lives remain severely constrained. The recent experiences of Bangladesh and Egypt, both predominantly Muslim countries, are illustrative in this regard. Since the late 1970s, rural and urban areas in both countries have experienced steady declines in fertility, with recent declines in rural Bangladesh similar to those in rural Egypt, despite lower levels of development and higher rates of poverty. This paper provides an in-depth exploration of the demographic transition in these two societies as seen through the dual lens of …
On The Quantum And Tempo Of Fertility, John Bongaarts, Griffith Feeney
On The Quantum And Tempo Of Fertility, John Bongaarts, Griffith Feeney
Poverty, Gender, and Youth
Demographers have known since the 1940s that standard measures of period fertility, such as the widely used total fertility rate, are distorted by changes in the timing of childbearing. Period fertility rates are depressed during years in which women delay childbearing and inflated in years when childbearing is accelerated. This problem is usually ignored because there has been no generally accepted method for solving it. This study proposes a method for removing the tempo distortions from the total fertility rate. The key assumption of the method is that period effects, rather than cohorts effects, are the primary force in fertility …
Social Networks And The Diffusion Of Fertility Control, Mark R. Montgomery, John B. Casterline
Social Networks And The Diffusion Of Fertility Control, Mark R. Montgomery, John B. Casterline
Poverty, Gender, and Youth
Theories of the fertility transition now routinely reserve a place for diffusion effects. Two fundamental behavioral mechanisms account for such effects: social learning and social influence. Social learning refers to the acquisition of information from others. The information might have to do with a new technology or with the health, social, and economic consequences of decisions. In the case of fertility, individuals might learn from others about the availability of a new contraceptive, or about health side effects of certain contraceptives, or about the apparent gains and losses from having fewer children and investing in their schooling. Social influence refers …
Government And Fertility In Transitional And Post-Transitional Societies, Geoffrey Mcnicoll
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 …
The Impact Of Family Planning Household Service Delivery On Women's Status In Bangladesh, James F. Phillips, Mian Bazle Hossain
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 …
The Onset Of Fertility Transition In Pakistan, Zeba Sathar, John B. Casterline
The Onset Of Fertility Transition In Pakistan, Zeba Sathar, John B. Casterline
Poverty, Gender, and Youth
Recent trends in fertility and contraceptive prevalence indicate that the marital fertility transition in Pakistan, which has been anticipated for three decades, has begun in the 1990s. Before that decade, the total fertility rate had exceeded 6 births per woman for at least three decades, and fewer than 10 percent of married women practiced contraception. The most recent survey data, collected in 1996- 97, show a total fertility rate of 5.3 births per woman and a contraceptive prevalence rate of 24 percent. Underlying this development are macroeconomic trends that have led to widespread economic distress at the household level, and …
Fertility And Reproductive Preferences In Post-Transitional Societies, John Bongaarts
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 …
Reproductive Control In South Africa, Carol E. Kaufman
Reproductive Control In South Africa, Carol E. Kaufman
Poverty, Gender, and Youth
The controversial state-sponsored family planning program officially began in South Africa in 1974. Although the government did not implement the program on a racial basis, the program was widely believed to be linked with white fears of growing black numbers, and was attacked by detractors as a program of social and political control. In spite of the hostile environment, black women’s use of services steadily increased. Using historical and anthropological evidence, this paper delineates the links between the social and political context of racial domination and individual fertility behavior. It argues that the quantitative ‘success’ of the family planning program …