Increasing contraceptive use in Bangladesh: The role of demand and supply factors

This article analyzes the determinants of contraceptive use in Bangladesh, focusing on the roles of demand for additional children and of family planning service supply. Data from the Matlab Family Planning Health Services Project are used to examine the contributions of these factors to the difference in prevalence of modern contraceptive use between the project area and a control area served by the government family planning and health programs. Results of multivariate analysis deriving from the Easterlin synthesis framework show the importance of family planning supply factors in reducing psychic and resource costs of fertility regulation and in activating latent demand for contraception. Demand for birth limiting and for birth spacing emerge as important explanatory factors; demand for birth spacing is greater in the project area, and both demand measures exert a stronger effect on contraceptive behavior in that area.     

Community-level determinants of contraceptive use in the Philippines: A structural analysis

We use household and community data from the Philippines to estimate a multilevel model of contraceptive use. We go beyond previous efforts in this field by developing a structural model that recognizes joint endogeneity and the temporal ordering of variables, by considering a wider range of community influences on fertility behavior, and by employing an econometric procedure allowing for a multilevel error structure. The results suggest that there are significant effects on fertility behavior of community-level family planning services, labor-market conditions, and infrastructure development. These results provide insights regarding the structural determinants of contraceptive use and fertility that are useful for drawing policy implications.     

Secrecy and silence: why women hide contraceptive use

A recent Population Council survey of 1860 married women and 1056 of their husbands in urban Zambia found that many women who use contraception do so without their husbands' knowledge and that those women who hid their practice of contraception from their husbands did so because they found it very difficult to bring up the subject of family planning with them. These findings indicate that low levels of contraceptive use are not the result of a simple communication matter. Sex and sexuality are often the exclusive domain of African husbands. As such, if a wife initiates a discussion of family planning, she may threaten her husband's sense of control and create discord within the family. The culture of silence about sex and sexuality is very strong in Africa. 57% of women stated that were they to propose contraceptive use with their husbands and the husband opposed such practice, they would nonetheless use them without his knowledge. 7% of the women stated that if their husbands disapproved of contraceptive use, they would nonetheless openly use a method against his wishes. The majority of women correctly perceived their husbands' views on family planning use and fertility preferences. In focus groups, both men and women said that they did not believe that women have the right to independently act upon their reproductive preferences. A husband's inadequate financial support of his children could, however, justify clandestine contraceptive use. These findings point to the need to include easily hidden methods in the mix of contraceptives family planning programs offer. Moreover, service providers should not automatically encourage husbands' involvement. A client's right to privacy should always be respected.     

Trends and determinants of contraceptive use in Kenya

This study uses the 1977-1978 Kenya Fertility Survey and the 1989 Kenya Demographic and Health Survey to examine trends and determinants of contraceptive use in Kenya. A substantial increase in contraceptive use occurred in Kenya over the decade. Yet although the increase was shared by all groups in the country, the amount of change differed greatly. A regression decomposition procedure revealed that shifts in population composition--that is, an increase in better educated women and in the proportion of women who want to cease childbearing--were the primary sources of aggregate change in contraceptive use.     

Strength of fertility motivation and contraceptive use in Nepal

The study's purpose was to test whether new survey questions on strength of fertility motivation, included in Nepal's 1986 Fertility and Family Planning Survey, enable improved prediction of current contraceptive use. Intent to use contraception in the future was also tested, over and above the effects of socioeconomic background. While controlling selected demographic and socioeconomic background characteristics of the respondents, the authors found the effect of the strength of fertility motivation on current contraceptive use to be substantial and highly significant statistically. Nevertheless, the background factors largely captured the effect of motivational strength on current use when motivational strength was deleted from the model, inasmuch as measures of global fit declined only slightly as a consequence of the deletion. These findings indicate that respondents' demographic and socioeconomic background characteristics affect motivational strength, so that motivational strength does not have a large independent effect on use. These results raise the question of whether strength of fertility motivation can be affected by educational efforts mounted by family planning programs to increase contraceptive use. The analysis shows that strength of motivation does have some independent effect on contraceptive use, and it is quite possible that this independent effect could be enhanced by educational programs operating independently of the socioeconomic characteristics of program recipients. Because the 1986 survey lacks relevant data, we have not been able to explore this possibility empirically.     

Child schooling and contraceptive use in rural Africa: A Ghanaian case study

In this study, I examine the contributions of childrens schooling to fertility decline in Africa. I use cross-sectional data collected in the late 1980s to look at how household child schooling patterns and community access to schools affect contraceptive use among rural Ghanaian women. My results indicate that the schooling of children is associated very strongly with increased use of modern and traditional contraceptive use and thereby suggest that educational policy has played a role in initiating and sustaining fertility decline in Ghana and possibly elsewhere in Africa.     

Spousal communication and contraceptive use among the Yoruba of Nigeria

A noted feature of many less developed societies is that marital partnershardly discuss reproductive issues with the result that decisions on theseissues are usually taken by men and their kinsmen. Because of lack ofspousal communication, negotiation for individual reproductive preferenceshas been limited. Thus, the reproductive preferences of men who desirelarger family sizes and oppose contraceptive use have usually been foundto prevail. The need to encourage husband-wife communication aboutreproductive issues cannot be overemphasized. The present study examinesthe level of spousal communication and its impact on contraceptive useamong Yoruba couples in southwest Nigeria. Data for the study are obtainedfrom a survey on the Role of Men in Family Planning conducted in one of thestates inhabited by the Yoruba of Nigeria – Ondo. The sample for this study consists of 381 monogamously married couples. Multivariate analyses were used to determine the impact of background variables on dependent variables. The study shows that fairly high percentages of men and women perceive that decisions on reproductive issues are taken jointly by both partners. The significantly high proportion of women who perceive that they participate in decision making is particularly worth noting and is an indication that women's voices are heard in the study society. Although the impact decreases on controlling for other variables, spousal communication was found to affect contraceptive use: contraceptive is higher among marital partners who discuss and take joint decisions on contraception. The study also reveals that family planning counseling has a significant impact on contraceptive use.     

Quality, accessibility, and contraceptive use in rural tanzania

We examine how informants' reports on community perceptions of the quality and accessibility of family planning facilities relate to the use of modern contraceptives by individuals in rural Tanzania. Using information on individual-level contraceptive use in conjunction with community-level information on the accessibility and quality of family planning facilities, we employ two distinct statistical procedures to illustrate the impacts of accessibility and quality on contraceptive use. Both procedures treat the community-level variables as imperfect indicators of characteristics of the facilities, and they yield nearly identical implications. We find that a community-level, subjective perception of a family planning facility's quality has a significant impact on community members' contraceptive use whereas other community measures such as time, distance, and subjective perception of accessibility have trivial and insignificant direct impacts, net of the control variables. Future research that uncovers the determinants of perceptions of both community-level and individual-level quality could provide key insights for developing effective and efficient family planning programs.     

Forum 4: the environmental privilege of borders in the anthropocene

ABSTRACT

Mobility can indicate a powerful or privileged relationship with one’s environment. The ability to exercise mobility or not (of oneself or others) is an exertion of power that demarcates where particular people belong and under what kind of environmental conditions. This essay focuses on the significance of borders in creating environmental privilege in the Anthropocene. Environmental privilege is accrued through the exercise of economic, political, and cultural power that enables the construction of exclusive environmental amenities such as clean air and water, open space, and safe neighborhoods. For years, environmental justice scholars have revealed the burdens and oppressive conditions associated with environmental inequality, but few studies consider the flipside of that reality. We argue that environmental privileges enjoyed by some rest upon the manipulation of the mobility of others – human and nonhuman. We believe border making will come under greater pressure as the effects of climate change increase, and the volume of resources required to maintain exclusive spaces intensifies. Continued mass migration will bring heightened anxieties about national identity and calls for greater border enforcement, despite the reality that borders – both literal and figurative – consistently fail to alleviate migratory pressures while exacerbating the effects of climate change and environmental injustice. Our research shows that greater ecological instability increases efforts to create privatized places as pristine spaces untouched by global turmoil, thereby reinforcing those social forces that produce environmental injustices in the first place.     

The determinants of the duration of contraceptive use in China: A multilevel multinomial discrete-hazards mdeling approach

Often in demography, individuals may change state over time for a variety of reasons. Competing-risks hazards models have been developed to model such situations. This paper describes the extension of the discrete-time competing-risks hazards model to a multilevel framework that allows for data at different levels of aggregation. The model is illustrated with data from the 1988 Chinese National Survey of Fertility and Contraceptive Prevalence, which collected complete contraceptive histories. Women may stop using a method of contraception for a number of reasons; this paper describes how one can control for correlations between the outcomes of repeated spells of contraceptive use.     

Beyond the Border and Into the Heartland: Spatial Patterning of U.S. Immigration Detention

The expansion of U.S. immigration enforcement from the borders into the interior of the country and the fivefold increase in immigration detentions and deportations since 1995 raise important questions about how the enforcement of immigration law is spatially patterned across American communities. Focusing on the practice of immigration detention, the present study analyzes the records of all 717,160 noncitizens detained by Immigration and Customs Enforcement (ICE) in 2008 and 2009—a period when interior enforcement was at its peak—to estimate states’ detention rates and examine geographic variation in detention outcomes, net of individual characteristics. Findings reveal substantial state heterogeneity in immigration detention rates, which range from approximately 350 detentions per 100,000 noncitizens in Connecticut to more than 6,700 detentions per 100,000 noncitizens in Wyoming. After detainment, individuals’ detention outcomes are geographically stratified, especially for detainees eligible for pretrial release. These disparities indicate the important role that geography plays in shaping individuals’ chances of experiencing immigration detention and deportation.     

Measurement issues involved in examining contraceptive use among young single women

The objective of this study was to determine how research findings on contraceptive use among young single women are affected by differing operational definitions of contraceptive use. Data were analyzed from a student sample and a clinic sample. In the analysis of the student sample were 244 high school and college women aged 16–22 who had experienced sexual intercourse. In the birth control clinic sample were 432 women aged 13–20. Six operational definitions of contraceptive use were analyzed. Correlation and multiple regression analyses were used to examine the relationship of predictor variables with the six definitions separately for each sample. The variance explained for each of the contraceptive measures ranged from 8 percent to 44 percent in the student sample and from 9 percent to 24 percent in the clinic sample.     

Population estimates for Bangladesh: The use of a specific transitional population model

Summary The development of population in Bangladesh was affected by a succession of man-made and natural calamities, such as the Bengal Famine of 1943, refugee movements following the partition of India and Pakistan in 1947, devastating floods and cyclones around 1970, and the military action during the war of liberation. Though there had been a tradition of census taking and vital registration in Bangladesh, as part of the Indian sub-continent, extending for over a century, vital registration was so deficient as to be almost valueless, and there were gross misstatements of age and under-enumeration in the censuses. In the census of 1941, on the other hand, political manoeuvring led to a substantial overcount of the population. In this paper, Bangladesh population trends are studied within the broader framework of the subcontinent, taking account of plausible differentials. A considerable element of uncertainty was introduced into growth trends as a result of variations in the completeness of census-taking and of unrecorded refugee and labour movements across open land borders. In this connection the substantial inflationary bias associated with techniques of population estimation using the dual record system is discussed. The application of stable population models is even less justified in Bangladesh with its history of declining mortality. A transitional age structure model was constructed on the basis of the information available on declining mortality and accelerating growth and the model was made even more specific by modifications which took care of the impact of recent calamities and of unrecorded migration. The population base of the census of 1961 was adjusted in accordance with this model. The local mortality age pattern was used in projecting the population by sex and age groups to the date at which the census was originally due to be taken in 1971, and to the date when it was actually taken in March 1974. The post-1970 calamities and their effect on mortality were ignored. The aggregate estimate of population of 72.9 million in March 1974 is slightly in excess of the census count (by about two per cent) reported provisionally as 71.3 million. The excess in our estimate could be accounted for by the losses due to cyclone and military action.     

The family building life course and contraceptive use: Nang Rong, Thailand

This paper incorporates the insights of the life course perspective in an examination of the determinants of contraceptive use. It views decision-making about contraceptive methods in the context of personal history and the broader social setting. Three stages in the reproductive life course of married women are considered. In the early years, timing decisions dominate. Contraception is used to delay the first birth and control the tempo of fertility. Mid-career, the major concern is whether to have a sterilizing operation. Towards the end of the fecund period, couples must decide when to stop using contraception, given that they have not already opted for sterilization. We examine choice among nonpermanent methods, as well as sterilization, in the context of a theoretical model that explicitly recognizes the permanence of the sterilization decision. Our statistical procedures control for unobserved community influences. The data are from Nang Rong district, Thailand, a relatively poor area near the Cambodian border under going substantial socioeconomic change during the 1980s. Our results clearly show variation in method choice over the reproductive life course, and variation in the effects of specific determinants including age of husband and wife, living arrangements, and village location. They also demonstrate gains in the understanding of any particular stage in the life course that accrue from an integrated examination of all of them.     

Dynamics of contraceptive use and breastfeeding during the post-partum period in Peru and Indonesia

This paper examines the interaction between contraceptive use and breastfeeding in relation to resumption of intercourse and duration of amenorrhea post-partum. We used data from the month-by-month calendar of reproductive events from Demographic and Health Surveys (DHS) in Peru and Indonesia. The analyses show that breastfeeding women were less likely than non-breastfeeding women to have resumed sexual intercourse in the early months post-partum in both countries. In Peru, but not in Indonesia, breastfeeding women had a significantly lower odds than non-breastfeeding women of adopting contraception. Although the likelihood of contraceptive adoption was highest in the month women resumed menstruation in both countries, about ten per cent of subsequent pregnancies occurred to women before they resumed menses. These results emphasize the importance of integrating breastfeeding counselling and family planning services in programmes serving post-partum women, as a means of enabling those who wish to space their next birth to avoid exposure to the risk of a pregnancy that may precede the return of menses.     

Psychosocial maturity and teenage contraceptive use: An investigation of decision-making and communication skills

The developmental factors influencing teenage women's contraceptive decision-making with first sexual partner are investigated. A discriminant function analysis of results of a study of 17- to 19-year-old women shows the following: Pill users are distinguished from women who have not used any method by having had a longer relationship with their partner, having a more negative attitude towards becoming premaritally pregnant themselves, being older at the time of their sexual debut, engaging in more frequent sexual intercourse, being more trusting of their partner, and perceiving the risks of unprotected pregnancy as greater. Women who are protected by the use of condom are distinguished from women not protected by any method by having had more discussions with male friends about a variety of topics, having better role-taking skills, having a less negative attitude about becoming premaritally pregnant, and having discussed their sexual debut with their partner beforehand. Results are consistent with a conceptualization which distinguishes contraceptive methods on the basis of the psychosocial costs their use incurs for young women.Research supported by Grant #HD09813, National Institute of Child Health & Human Development. Thanks are due to Robin Halliday, Allyson Myhre, and Carolyn Scheve for help in conducing this investigation.     

Sexual activity and weekly contraceptive use among young adult women in Michigan

Past studies on the influence of sexual activity on contraceptive behaviours are inconclusive, relying heavily on cross-sectional data. We used a population-based longitudinal sample of young women in Michigan to evaluate weekly associations between sexual activity and contraceptive use at three levels of measurement: comparing between women, among individual women’s partnerships, and from week to week within partnerships. We used multinomial logistic regression accounting for correlations within partnerships and women. Relative to use of least effective methods, weekly sexual activity was significantly associated with increased use of condoms, pills, and highly effective methods. For pills and highly effective methods, partnership-, woman-, and week-level effects were similar. For condoms, there was no significant woman-level effect. Evidence of immediate effects of sexual activity on contraceptive use highlights the importance of longitudinal data. These dynamics may be diluted or missed altogether when relying on cross-sectional data approaches that compare groups of individuals.     

Social networks and changes in contraceptive use over time: evidence from a longitudinal study in rural Kenya

The impacts of social networks on changes in contraception in rural Kenya are investigated using special data from a longitudinal household survey. An analytic model, informed by detailed knowledge of the setting, yielded estimates that indicate that (1) social networks have substantial effects even after unobserved factors (e.g., homophily) that may determine social networks are controlled; (2) controlling for these unobserved factors may substantially alter the estimated effects of networks (these controls were not used in previous studies); (3) network effects are important for both men and women; and (4) network effects are nonlinear and asymmetric, suggesting that networks provide information primarily through social learning, rather than by exerting social influence.     

A multilevel model of family planning availability and contraceptive use in rural Thailand

This paper assesses the ways in which the availability of family planning program outlets influences the likelihood of contraceptive use in rural Thailand. It focuses on a village-level measure of actual availability of sources rather than respondent perceptions of availability. Individuallevel and village-level data collected as part of the second Thailand Contraceptive Prevalence Survey are used to test three hypotheses about the effects of actual availability: that (a) availability of family planning outlets increases the likelihood of contraceptive use; (b) it enhances the effect of a desire for no more children on the likelihood of use; and (c) it weakens the positive relationship between education and the likelihood of use.     

Binary outcomes and endogenous explanatory variables: Tests and solutions with an application to the demand for contraceptive use in tunisia

Many demographic studies examine discrete outcomes, and researchers often suspect that some of the explanatory variables may be influenced by the same unobserved factors that determine the discrete outcome under examination. In linear models, the standard solution to this potential endogeneity bias is an estimator such as two-stage least squares. These methods have been extended to models with limited dependent variables, but there is little information on the performance of the methods in the types of data sets typically used in demographic research. This paper helps to fill this gap. It describes a simple analytic framework for estimating the effects of explanatory variables on discrete outcomes, which controls for the potential endogeneity of explanatory variables. It also discusses tests for exogeneity and joint determination of the outcomes and the explanatory variables. It summarizes the results of a Monte Carlo study of the performance of these techniques and uses these results to suggest how researchers should approach these problems in practice. We apply these methods to the examination of the impact of fertility intentions on contraceptive use, based on data from the 1988 Tunisia Demographic and Health Survey.