A study in family planning communication—Direct mailing

It is sometimes stated that direct mailing to individuals in developing countries like India may be wasteful due to the low literacy rate among village people. Direct mailing is a relatively new development in India and comparatively a newer channel of communication. An exploratory study was carried out by the Central Family Planning Institute to test this hypothesis. The observations made showed that direct mailing is practical, controllable, inexpensive, and useful.The information provided by direct mailing seems to cross the barriers of illiteracy. Based on this experience, the Central Family Planning Institute has initiated a large-scale communication action research project in Meerut district in North India where the impact of direct mailing on specific groups is being studied further. It is hoped that such studies would help in developing prototype information material and would provide a methodology to supplement the available channels of communication in a nation-wide family planning program.     

Analysis of participant reactions to a series of family planning training events

Intrah conducts training in family planning for health workers in Africa and Asia. This paper assesses the training on the basis of reactions of participants and a model that views participant reactions as a function of characteristics of the setting in which the training takes place, training event, and the participants. Data are participant reactions from 1659 trainees in 92 events from 1984 to 1987. Factor analysis is used to reduce fifteen participant reaction items to a smaller set of dimensions. Regression analysis is used to test the conceptual model. Analysis produced five participant reaction factors, usefulness of the training, practicality of the training, presentation, a trainer rating and extent of activity. Between twenty six and fifty six percent of the variance in these measures is accounted for by the variables selected on the basis of the conceptual model.     

Assessing the impact of a family planning nurse training program in Egypt

In 1991 the Egyptian Ministry of Health introduced a new training program for family planning nurses. The training program stressed the development of nurses' counseling skills. As part of the Operations Research Program, sponsored by Family Health International in collaboration with the Egypt National Family Planning Board, managerial staff from family planning agencies designed and implemented a study to evaluate the impact of the new training program. The study objective was to assess the impact of nurse training on nurse performance in the clinic and on clients' family planning knowledge, attitudes and contraceptive use. The study was designed to provide usable information to family planning managers in the field within a time period of less than one year. The study results indicate that there is an association between improved family planning training for nurses and positive changes in family planning knowledge, attitudes and behavior among women attending MoH clinics in this study. The greatest relative change occurred in knowledge. Women in the experimental group, relative to the control group, displayed increased knowledge about contraceptives, particularly the pill and the IUD. Attitudinal change was less pronounced. Favorable attitudes toward oral contraceptives and condoms became more prevalent, and reports of husband-wife communication about family planning also increased. Finally, although contraceptive use was already high prior to the nurse training, IUD use increased significantly among women in one governorate.     

The need for family planning

The purpose of this paper is to examine the evidence on the need for family planning. The available evidence on current levels of unmet need for contraceptives, fertility preferences, and the non-contraceptive benefits of family planning is reviewed. I argue that expansion of family planning programs is still needed. These programs provide couples with tools to reach their desired family size; can significantly impact maternal and child mortality by decreasing fertility and optimizing child spacing; and by decreasing fertility, slow population growth. It is therefore imperative to continue to expand the provision of family planning services.     

A welcome family planning service center

The Family Planning Service Center of Luohu District was organized by the Family Planning Committee of the district to help couples of child bearing age and 1-child families to overcome their difficulties. The services provided by the center include: distributing contraceptives, and providing consultation on birth control, contraception, healthy births and better upbringing, and maternal and child care. A peculiar feature of the center is that one sees many young and middle-aged people of both sexes going in and out of the place at all hours of the day and night. Workers from the center even go to offices and factories to provide services and distribute contraceptives. In close cooperation with neighborhood family planning centers, the center has also set up offices to distribute contraceptives and give advice. It is estimated that in Luohu District, at present, 90% of the couples of childbearing age are current users of contraceptives. In the city, the proportion of 1-child families is quite large. As a rule in China, preschool children are looked after by their grandparents. Living separately from their parents, however, many couples in the city find it difficult to find someone to care for their children. The center also provides assistance in finding child care help. The center has also invited experts and medical personnel to give 10 lectures on child nutriology, child psychology, birth control, contraception and pregnancy health.     

Effects of various factors on selection for family planning status and natural fecundability: A simulation study

The effect of various factors on selection for family planning status and for natural fecund ability is studied in a simulation that incorporates a beta distribution of fecundability among women. The mean fecundabilities of current spacers, current limiters, current nonusers, and pregnant women are compared. These ratios are influenced by duration of marriage and by desired number of children. Effects of different levels of contraception are measured. Another strategy, spacing the last two wanted births, is also studied. It is found that breast-feeding status has little effect on fecundability selection. The women usually found to have greatest fecundability are not those recently pregnant at durations of marriage five and ten years, unless they wanted fewer than two children, but rather those who are using contraception to limit the number of children.     

A second look at natural family planning

There is renewed interest in natural family planning (NFP) as the Philippine Population Program enters the 1980s. Much of this interest is due to the realization that, properly practiced, NFP can be a highly effective means of birth spacing. In 1978 the Special Committee to Review the Philippine Population Program recommended that more efforts be made to promote NFP. The different methods of NFP are reviewed. Sex without intercourse, coitus interruptus, and prolonged nursing are not officially recognized as NFP methods by the Program. The rhythm method was first described independently by Drs. Hermann Knaus of Austria and Kyusaku Ogino of Japan in the 1930s. Ogino's method of calculating a woman's fertile period is based on the lengths of the last 12 menstrual cycles which she recorded on a calendar. The advantages of rhythm are that it is inexpensive, it requires only the cost of charts which may be homemade, there are no physical side effects, control is in the woman's hands, and it is acceptable to people who consider it their duty to follow religious teachings. Disadvantages include: keeping constant, accurate records of cycles for long periods of time; the need for perseverance and correct interpretation of the chart; the possible need for medical advice and help; and the fear that something might upset a woman's cycle and change the time of ovulation. The continuation rates of rhythm acceptors in the Philippines are unimpressive. A study of 142 women revealed a high pregnancy/failure rate--25% for a 12-month period compared to 0 with oral contraception (OC) and the IUD's 2%. The basal body temperature method helps determine the unsafe period with some accuracy. Its premise is that there are slight but detectable changes in a woman's body temperature during her cycle. These changes herald ovulation. A special thermometer must record temperature changes of 0.1 degree Farenheit. This instrument and the charts are the only expenses involved. The reviewers of the Philippine Population Program noted that since the end of the unsafe period can be indicated only by the temperature, the total period of abstinence becomes long, although the basal body temperature method gives more or less 10 successive days for intercourse. The cervical mucus method, also known as the Billings method, takes into account the cervical secretions during the menstrual cycle. Appearance of this mucus is an indication of fertility. All that is required of a practitioner is to learn to distinguish the different sensations of wetness and dryness. The disadvantage is that the method becomes ineffective in areas where there is cervicitis or infection of the cervix. The symptom thermal method is the basal body temperature method combined with other NFP techniques and is widely used. With this method an accurate record of the 6 immediately preceding menstrual cycles is established. The start of the fertile period is set by substracting 20 days plus 1. The woman watches for symptoms like pelvic heaviness, breast softness, and mucus discharge.     

A fresh look at family planning communication

As a step toward development of a national information, education, and communication (IEC) plan, a reassessment of such efforts practiced by the agencies involved was undertaken. A paper published in 1978 by the Research Utilization Unit of the Population Information Division, Population Center Foundation, reviewed materials used and accounts of experience in conceptualizing and communicating family planning messages by 12 private and public sector agencies. The most common concepts employed by the agencies were small family size, responsible parenthood, family welfare, community and national development, birth spacing, delayed marriage, contraceptive use-effectiveness, "manliness," delayed 1st pregnancy, value and rights of children, human behavior and social environment, and population dynamics. Most of the messages were conceptualized and developed through formal and informal consultation with field staff. The need to consider the specific needs of target audiences was considered crucial, and thus decentralization of IEC production was recommended. Such decentralization has been a goal of the Philippine program since 1976, but the effort has been hampered by lack of local training and resources, and of studies to support successful implementation. Mass and mixed media approaches were found to be used by most of the agencies, although a reliance on interpersonal approaches was found to be most prevalent in rural areas. Among recommendations for policy makers were development of a systematized data base for IEC materials, regional capabilities in research and development, and studies of funding and existing resources.     

Jiang Sannu's home clinic for family planning

Jiang Sannu, a physician in China's Jiang Jia Village (Shaanxi Province), opened a family planning clinic in her own home in March 1987 to increase accessibility to contraceptive supplies and information among rural couples. Jiang was the elected head of the village women's federation. During the day, Jiang Sannu travels door-to-door throughout the village, providing information on issues such as prenatal care, breastfeeding, and family planning policy and methods. She provides gynecologic and pediatric medical services as well as midwifery. The nearest maternity hospital is 2-3 kilometers from the village, so Jiang has to date delivered over 20 infants. In the evenings, she disseminates Communist Party Central Committee documents on family planning regulations through the village tweeter. There is widespread agreement among villagers that this family planning facility is well suited to the needs of the local community.     

A brief introduction to China's family planning programme

China's family planning program is described in reference to its goals, approaches, and achievements. Between 1949-83, China's population increased from 541 million to 1,024,950,000. The population has a young age structure, and the median age is 22.9 years. 80% of the population is rural, and 90% of the population lives in the southeastern region of the country. In view of this demographic situation, the government recognizes the need to control population growth. China's goals for the year 2000 are to increase industrial and agricultural input by 400% and to keep population size below 1.2 billion in order to ensure that per capita income increases. In accordance with these goals, the government, in 1979, began advocating a 1-child policy. To ensure the survival of single children, the government also launched a program to upgrade maternal and child health (MCH). In some rural areas and among certain minority groups, the 1-child restriction is not applied. Family size goals will vary with time. These variations will reflect the need to maintain a balance between economic growth and population growth. A variety of incentives are used to promote the 1-child family. For example, single children receive medical and educational benefits, and in some rural areas, the parents of single children can obtain additional land contracts. Economic disincentives are also used. The government seeks to obtain compliance with the policy primarily through educating the public about the consequences of uncontrolled population growth. All channels of the mass media are used to deliver the messages, and the publicity campaign is especially intensive in rural areas. A comprehensive plan to provided family planning and population education for middle school students is currently being implemented. Each local area develops its own fertility control plan. This plan is then incorporated into the nation's overall plan and the overall plan is implemented from above. Family planning workers bring free contraceptives directly to the people, and family planning motivators are found in almost all villages, neighborhood committees, factories, and military units. As a result of these efforts, China made great strides in controlling population growth and improving MCH during the last decade. The birth rate declined from 27.93 to 18.62, and the total fertility rate declined from 4.01 to 2.48. 124 million couples were practicing contraception by the end of 1983. 41% used IUDs, 37.4% relied on tubal ligation, 12.9% relied on vasectomy, 5.1% on oral contraceptives, and 1% on other methods. The quality of maternal and child care also improved. 92.7% of all deliveries are now performed by trained midwifes. Infant and maternal mortality rates declined considerablely in recent years. Currently the respective rates are 35.68/1000 live births and 0.5/1000 live births. In 1983 alone, the gross national agricultural and industrial output increased by 46.1%. Since 1979 per capita income increased annually by 18.3% among rural residents and by 10.7% among urban workers. China controls and operates its own population program, but in recent years, it increased its cooperation with UN Fund for Population Activities, other UN agencies, and nongovernment agencies. China recently completed its 3rd national census, and demographic research institutes have been established in 10 universities.     

A theoretical framework of collective action for the evaluation of family planning programs

Typically, a family planning program seeks to alter individuals' fertility behavior. The very necessity for the existence of a family planning program presumes that individuals' fertility expectations and behavior are not yet consistent with the objectives of the program. Therefore, some individuals may choose not to cooperate. In this article I establish a theoretical framework for the evaluation of family planning programs by synthesizing the literature on the theory of collective action. Because of the characteristics of collective action — indivisibility and externality — noncooperation (free riding) is bound to occur. Faced with the problem of free riding, a good family planning program should ideally apply selective incentives, localize the costs and benefits, and invest in social capital. The relations among these three factors, cooperation, and fertility are also spelled out.An earlier version of this article was presented at the annual meeting of the American Sociological Association, Washington, DC, 11–15 August 1990.     

颁布、施行人口与计划生育法对人口与计划生育工作的挑战

颁布、施行人口与计生法为加强人口与计生工作提供了法律保障 ,无疑是一件大好事。但是 ,特殊的国情决定了实施人口与计生法会遇到许多困难和问题 ,对人口与计生工作的思路、方法 ,对人口与计生工作的任务、要求 ,对人口与计生工作的作风、工作效率 ,等等 ,都是一种挑战。因此 ,我们必须采取有力措施 ,积极应对这种挑战 ,切实搞好依法管理 ,依法实行计划生育     

A broadcast on family planning in Hefeng County]

New ideas for the promotion of family planning among distant regions is the objective of this report which states that rural communities lack effective means of communication mainly due to poor transportation facilities, a serious illiteracy problem, and the fact that in certain regions, households are virtually inaccesible because of mountainous terrain. Such is the situation in He Feng County, Hubei Province, in southern central China. It has a population of 180,000 people composed of 3 ethnic groups. The communication barriers mentioned above act to hinder the promotion of effective family planning. In a study carried out in He Feng County, it was found that bad transportation facilities were a contributing factor to the region's backward education. Moreover, the illiteracy and semiilliteracy rates in He Feng County comprise 20% of the population. The problem is compounded by the fact that its 40,000 households are scattered throughout the mountains. In an effort to combat the prevailing situations, the author suggests that an effective means of family planning promotion would be the installation of loudspeakers in almost every household in the county (a total of 25,000 loudspeakers). This would provide suitable family planning education to males and females of different age groups and would foster knowledge of its significance and importance, thereby changing existing rural attitudes about family planning. Furthermore, the government could provide support groups in these regions in order to promote family planning objectives.     

A sensitive approach to family planning motivation in Malaysia

The goals of the Malaysian Family Planning Program are not only to reduce population growth from 3% to 2% by 1985 and to bring the crude birth rate to 28.2 from 30.3, but to generally improve the health of the family, and to enhance the government's efforts to raise the per capita income. The work program is divided into the Creative Unit, the Media Unit, the Production Unit, and the Field Diffusion Unit. The objectives are to build up strong support from political, community, and opinion leaders, and to run educational campaigns aimed at motivating potential acceptors. The program also runs centers training medical and paramedical personnel. The program is combined with development programs for women, especially useful among the rural population.     

A cost benefit analysis of the barbados family planning programme

Abstract Of the Caribbean islands, Barbados has the lowest fertility level. The crude birth rate in 1970 was only 20·5 per 1,000, which is one of the lowest found in any country of similar economic development anywhere in the world. In 1960 the crude birth rate was much higher, at about 33·6 and for almost 40 years before that had fluctuated around a value of 33. Thus, a decline of about 40% has been achieved within the comparatively short period of a decade. The reasons for this rapid decline are of particular interest to all those concerned with population growth and economic development in the less developed areas. In Barbados, the importance of population control and the role of family planning was recognised early by the government and other civic agencies, and the Barbados Family Planning Association (BFPA), an autonomous national family planning agency, was established. Since its modest beginning in 1955 the BFPA has grown to be a major social institution, comprising 14 clinics situated in various localities throughout the island. In 1970, a full-time staff of 28 were providing services to an estimated 10,000 clients, about 20% of all women of reproductive age. Funds for the BFPA have come from local government with considerable assistance from international agencies.     

A grand gathering of model family planning workers in China

At the 1986 National Commendation Conference of Family Planning Vice Premier Wan Li told the 600 participants from all parts of China that the task of controlling population growth during the 6th Five-Year Plan had been accomplished and that the trend of population growth had been held in check. He emphasized the progress made in the field of family planning, noting that family planning is a basic state policy of China and that the government always regarded family planning as a priority concern. Wan Li made the point that the population control stipulated in the 6th Five-Year Plan is of great significance to the promotion of China's 4 modernizations -- socialist construction and the improvement in the living standards of the people -- as well as helpful to the stabilization of world population growth. Recommending a flexible approach to family planning, the Vice Premier urged those engaged in family planning to work to overcome compulsory and coercive approaches. He recommended scientific research devoted to birth control technology and asked family planning workers to give family planning a higher priority in order to assure fulfillment of the plan for population control as outlined in the 7th Five-Year Plan.     

Evaluation of family planning program performance: A critical review

Family Planning Program Evaluation is not a well-developed art, much less an exact science. The evaluation of the performance of such programs has received a good deal of attention but the methodologies are still controversial and the results inconclusive. This is due to a wide variety of constraints, not all of which are technical, and most of which are not unique to family planning. The prospects for improvement of FPPE depend, to a great extent, on overcoming these constraints.     

Natural family planning: A comparison of continuers and discontinuers

Little research has been done on social-psychological variables related to the use of natural family planning. The objective of this study was to analyze variables that differentiated between continuers and discontinuers of natural family planning (NFP). Questionnaires were obtained from couples who had received instruction in the sympto-thermal method of natural family planning at a large urban hospital. Subjects who were attempting to become pregnant or who were using other methods of contraception in conjunction with NFP were deleted from the analysis, leaving N of 74. With Pearson correlation, variables significantly related (p<.05) to NFP continuance were: religiosity, planning more children, perceived severity of pregnancy, support from spouse and relatives, dissatisfaction with other contraceptive methods, attitudes toward NFP, perceived effectiveness of NFP, attitudes toward abstinence, and importance of intercourse.     

A new terminal judgment method for family planning: indistinct comprehensive judgment]

The purpose of family planning (FP) program evaluation is to make comparisons between different work units and between the past and the present. The evaluation covers the impact of programs in economic, social, and demographic terms. If the impact is not quantified, it is difficult to distinguish differences in program performance. It is also hard to determine the relative standing of different organizations if each one has different merits and deficiencies. A mathematical model is used to quantify the performance of each unit in a FP program. 4 variables are used as the program indicators in the model: 1) percentage of child births following planning, 2) percentage of deferred marriages, 3) birth control prevalence, and 4) percentage of one child pledges. Indicators of social impact include 3 variables: 1) the attitude of FP workers, 2) the efforts of FP workers put in FP and 3) the results of program implementation. The indicator of economic impact is the investment for evasion of the birth of a child. Grades are assigned to indicators of social impact for each organization. The values of each variable is put in a matrix. Weights are given to each variable based on the emphasis of the program or a specific evaluation. The weights are determined through discussion with people involved in the program. A weighted average of all the above factors is the final grade of an organization's FP program performance.