Premarital information efforts under way

Premarital couples are among priority targets of family planning information in the Philippines national population program as they can serve a pivotal role in slowing population growth. Applicants for marriage licenses are required to attend a family planning session as a prerequisite. Following recommendations of a training effort and seminar on Premarital Family Planning Counseling, on July 20, 1976, premarital information was institutionalized in the country by Presidential DEcree 965 which made family planning counseling obligatory to the marriage license applicants. Shortly after that, a multiagency effort gathered information on the status of the Premarital information program in the Philippines, which showed that there is no full-time specialist for the work. Medical officers; social workers; community welfare supervisors; and program and training officers do this work of information in addition to their usual duties. Distribution of the applicants varied greatly in age groups, educational levels, and professional category. The size of the group, length of session and topics of discussion varied greatly. Necessary efforts should be made to solve the major problems by selecting better sites for group sessions and training more personnel for the purpose. There is a great need fordeveloping more effective and research oriented information, education and communication materials, according to the needs and cultural traits of the target audience.     

Bicol hospital reaches out to rural folk

The Ago General Hospital in Legaspi City of the Philippines was opened in 1965, antedating the national family planning movement by 5 years. The 180 bed hospital integrates family planning into the overall hospital service; sterilization is the main method used. Of the 3600 patients per year, 15% are family planning acceptors. The hospital employs 3 family planning strategies: inhospital, out patient and supportive. Inhospital strategies center on sterilization counseling and motivation. The counseling sessions include patient education. Primary targets include high risk pregnancies and young couples with a lot of children. Outpatient strategies include a referral system involving hospitals and agencies with family planning programs, lectures for community organizations and personal visits to other clinics and rural health units. The hospital's mobile clinic, staffed mainly by students, provides information, deworming, and pediatric services to the community. Supportive program strategies consist of mass communication, and an acceptor's club for previous acceptors of sterilization. These clubs meet regularly to share and discuss experiences.     

Upholding the freedom of couples to use a method of their choice

A recent review of the Philippine Population Program's 5-year plan, ended in December 1982, showed that in 1980, natural family planning (NFP) users were only about 12.5% of couples practicing family planning. This figure doubled by 1982. Based on these responses the decision was made to intensify the NFP program as early as 1982. The 1st step was to put more money into the NFP program. The program includes the modern scientific techniques such as cervical mucus, basal body temperature, and sympto-thermal. The program also will fund the training of doctors and other clinic personnel and the production and distribution of appropriate training and information material. Other family planning methods, such as sterilization, oral contraception (OC) and the condom, also will be promoted. Promotion of NFP will depend on the choice of the family planning practitioners themselves. The program's community based services are being intensified. NFP, together with the other family planning methods such as sterilization and OC, will always be made available to couples in the community based services. All agencies in the population and family planning program will be promoting NFP. Knights of Columbus doctors have been invited to assist the program and share their own training modules for the training of trainers. An agreement has been entered into with the Gabriel M. Reyes Memorial Foundation based in Aklan. The goal is for trainers who need further knowledge and skills in NFP to learn from the foundation's wealth of organized orientation and training techniques in NFP. NFP is emphasized at this time because it is acceptable to a great number of couples.     

Sex,counseling, and the young industrial worker

The Population Center Foundation (PCF) has begun promoting greater awareness of the implications of adolescent fertility among Filipino teenagers. PCF has developed an information and counseling program on adolescent fertility attuned to the youth's particular conditions and tastes. Almost all teenagers preferred to talk with their peers rather than with adults or professionals, especially on intimate topics. The export processing zone (EPZ) is 1 of the most popular government strategies for pursuing an export-led industrialization. The Bataan EPZ, the site for 1 implementation of PCF's program for young workers, is the country's prime industrial estate. The presence of dormitories in the Bataan zone has given greater opportunities for interaction among workers; closer relationships are built, and the degree of trust and intimacy required for honest discussions of sexual problems is established. The Bataan program aims to assist the EPZs, the regional and local offices of the Commission on Population, and the Ministry of Labor and Employment in meeting the family planning needs of the zones' teenage workers. An information-education-communication campaign has been launched to get support for the sexuality counseling services offered by various institutions in this program. Those who take part in the adolescent sexuality counseling training program are asked to share their experience during feedback sessions.     

Shuangyang County popularizes contraceptive knowledge

Shuangyang County is located in the southeast of the Changchun City, Jilin Province, with a total population of 385,000 and a total area of 2,000 square kilometers. The rural population makes up 96% of the total with 8.2% minorities. As the county government vigorously promoted the family planning program in the period of the 6th Five-Year Plan, the rapid growth of the population was effectively controlled. Since 1982, the county government has put the emphasis of the family planning work on publicizing scientific knowledge, on provviding technical services and on training the working staff at the grass-roots level. In response to the different needs of the community for knowledge about premarriage, preconception, and postnatal cares as well as infant feeding, the county government started a program in 1985 for popularizing knowledge about puberty, hygiene, sexual physiological hygiene, pregnancy care, and birth control. As a result, a number of young people have delayed their former marriage date to the ideal marriage age. Many newlyweds voluntarily chose the most proper age for giving birth. To improve the effectiveness of contraception, the county government promoted widely the use of a new type of IUD. Finally, the county government believes that it is most important to improve the quality of the family planning workers at the grass-roots level. Accordingly, the government worked out a plan to train the community workers regularly.     

The Significance of Living Together and Importance of Marriage in Same-Sex Couples

Because marriage has been denied to same-sex couples, it is likely that the meaning and significance ascribed to non-marital cohabitation may be unique. Further, it is unclear whether same-sex couples view marriage as important to their relationships, and if they do, why. Using qualitative data from 526 individuals in cohabiting same-sex relationships across 47 states, we explored (1) the meaning and significance of cohabitation and (2) the perceived importance of legal marriage to the relationship. Participants viewed cohabitation as significant, most commonly because it indicates long-term commitment, provides emotional support, makes the couple a family, and allows them to share life together. Marriage was perceived as important to a majority (90%), most commonly because it confers financial and legal benefits, relational legitimacy, and demonstrates the same commitment as different-sex couples. Overall, findings highlight the symbolic significance of cohabitation and importance of access to legal marriage to adults in same-sex relationships.     

Natural family planning works in a Bukidnon town

Natural family planning is being actively promoted in a pineapple plantation of the Philippine Packing Corporation (PPC) located in northern Bukidnon province. Prospective acceptors attend 4 seminars which cover sex education and instruction on natural family planning methods. The goal of the program is family life and marriage enrichment rather than family size limitation. Thus, there is no target number of acceptors. Early acceptors used the basal body temperature method, but this was subsequently replaced by the sympto-thermal method. Participants report that the close observation of physical changes required by the natural family planning method has enabled them to be more aware of their bodies and more appreciative of themselves. Laypersons work closely with acceptor couples. There are 6 fulltime grassroots motivators and 23 camp motivators. Affiliated with the Family Life Commission of the Catholic Bishops Conference of the Philippines, the program is also supported by the Phillips Memorial Hospital and is part of the PPC's barrio assistance program. The corporation actively supports self-help projects in the plantation areas.     

Magdamayan: drawing the family into community work

Magdamayan is an old word meaning to help one another; it has been chosen as an acronym for a program currently being undertaken by the Family Planning Organization of the Philippines (FPOP) that addresses itself to family life and community development -- a departure from previous FPOP projects. It aims to reach out to rural villages through 44 chapters covering selected communities in the 3 major island groups. Its main objectives are to reach the majority of the eligible population in each village, increasing the awareness, knowledge and understanding of family planning; to enlist 80% of eligible couples; and to maintain a 90% continuation rate. The 1st cycle of the project activities was begun in July 1975, divided into 3 phases spread over 18 months. Phase 1 involved preparations for the project in the villages, including a baseline survey. Phase 2 was the actual program phase, including a mass information drive, contraceptive promotion, identification of target groups, training of motivators, and provision of backup services. Phase 3 involved the phasing out of FPOP staff and turning the project over to community volunteers, and evaluation. Among the activities employed to facilitate integration of family planning into community life were 57 vocational skills training courses, various income generating activities (dances, sporting events, raffles) and community development projects. Preliminary evaluation of the 1st cycle indicates impressive success, but below the 80% acceptance and 90% continuation rates. Community development activities were seen as much enhanced, and basic health services and vocational skills training were successfully introduced. Constraints identified as limiting the success are discussed, and it is concluded that the program's performance this far is good enough to warrant its use as an alternate or model for similar family planning projects.     

Premarriage education in family planning should begin in puberty]

The work of disseminating family planning information must begin at puberty in order to provide a sound foundation for future family planning education. Premarital education that begins at puberty should emphasize decreasing the number of early marriages, planning for only 1 child, and superior births. The Chinese Family Planning Association held a special seminar in November 1986, in Taicang County, Jiangsu Province, to study sex education. Some observations by individual participants are included below and do not represent the viewpoints of the Conference. Education at puberty concerns 2 primary areas: knowledge about sex, and morals concerning sex. At this age, physical changes are met by immature minds. Adolescents are not informed about the sexes; nor do they understand self control. Families and teachers must help them comprehend physical desire and relationships. The first step in educating adolescents is to eradicate feudal attitudes that make sex a taboo subject and that equate it with obscenity. Sex education is scientific and must be disseminated as such. If proper objective information is not provided, adolescents will acquire the wrong, and sometimes detrimental, information from peers. Early marriage, abortions by unwed mothers and sex crimes can be prevented by proper education. In those schools, particularly in Shanghai, which have sex education, the reception has been positive among teachers and students. Although sex education is crucial to educating adolescents, it should not be confined to this age group. Engaged couples and newlyweds also need such information.     

Systematic and chance components in fertility measurement

Abstract A Monte Carlo simulation model of fertility is developed to incorporate a decline in fecundability with age of women as well as a variation between women, and a family planning strategy in which couples prefer certain sizes of families and seek to lengthen the last planned birth interval. In the simulation of family planning and non-family planning populations, segmental parity tables are computed. These are tables in which the numbers of women in the columns representing the completed family sizes are sub-divided by rows representing the sizes of the families for shorter durations of marriage. The couples' success in their plans, under various conditions, and the rapidity with which family sizes stabilize, are among the results obtained from the simulation. The application of the tables to the estimation of family size preferences from observed family size distributions is also discussed.     

Adolescent fertility programs: taking the first few steps

Adolescent fertility programs in Asia and the Pacific have a long way to go to check the problems associated with adolescent fertility, but a start has been made. Delegates from 8 countries met in 1982 to share their problems and experiences in their own countries. The conference participants drew up plans to deal with a high rate of adolescent fertility, sexually active adolescents, out-of-wedlock births, unwanted pregnancies, sexually transmitted diseases, prostitution, rape, abortion, and drug addiction. The delegates felt that for adolescent fertility programs to be effective the program workers must first be equipped with the needed skills through proper training. Inadequate knowledge of the subject matter, inability to communicate with adolescents, personal bias, and lack of counseling skills were among the worker-related problems that conference participants identified. A few months after the conference, participant countries conducted a training program on the effective delivery of adolescent fertility-related information and counseling services. The training program, held in Manila from January 23 to February 2, 1984, was conducted by the Population Center Foundation and sponsored by the Family Planning International Assistance. Training program objectives included: in crease the participants' knowledge of sexuality-related matters; help them to communicate better with adolescents on matters related to sexuality and fertility; make them aware of other ways of responding to fertility-related information needs of adolescents; and improve their skills in counseling adolescents. Lectures, structured learning activities, discussions, role playing, and other methods were used to maximize learning. The training program was divided into 6 modules: group dynamics; human sexuality; information dissemination; counseling techniques; management; and action planning. The plans of Fiji, India, Indonesia, Nepal, Sri Lanka, Thailand, and the Philippines are reviewed. Organizers of the training program are confident that the action plans of the individual countries will take shape soon and clear the path toward more effective adolescent fertility programs.     

Beyond population,beyond family planning: the Commission on Population's total integrated development approach

The Philippine Commission on Population (Popcom) after 5 years of operation has succeeded in reducing the national population growth rate from 3.01% in 1970 to 2.66% by the middle of 1975. More than 50% of the country's eligible couples are practicing family planning or have received services at some time. New acceptors recruited during the fiscal year 1974-1975 totaled 716,650 as compared with 191,426 in 1970. As of December 31, 1975, continuing users amounted to 22% of the population. Despite the accomplishments, however, the following operational problems exist: 1) 57 out of every 100 married women of reproductive age have not been reached by the program; 2) in all regions, only 2 out of 3, or even fewer, women are aware of the existence of a family planning clinic to serve them; 3) there is a definite shift from the more effective to the less effective methods of contraception; and 4) there is a large disparity between knowledge and practice of family planning among both urban and rural women. Additionally, the clinic-based system limits the program's outreach to urban areas, and the doctor-centered approach limits the provision of services. In response to these problems, Popcom developed the Total Integrated Development Approach in 1975. This approach is currently being implemented in 7 pilot provinces and under the auspices of this approach, various strategies have been developed to improve service delivery and to expand coverage of the rural areas. 1 such strategy is the establishment of barrio resupply points which are complemented by mobile clinics which service remote and inaccessible areas. Eventually, depending on the success of the program, the approach will be implemented in all provinces within the next 3 or 4 years. Each Total Integrated Development Approach will include the 4 components of services delivery, IEC (mass and interpersonal communication and special projects), training, and research and evaluation.     

再论“四二一”结构:定义与研究方法

"四二一"结构是中国低生育率背景下家庭结构与代际关系的一种特殊表达,既反映了20世纪70年代以来计划生育政策广泛推行对中国家庭的深刻影响,又揭示了中国现阶段婚姻家庭乃至未来人口发展的特点与趋势。目前这一领域的研究虽然已经取得一系列的进展,但在概念界定与使用的方法上仍缺乏共识,导致研究结论的分歧和研究拓展的迟滞。在中国社会剧烈变动的形势下,"四二一"结构是研究中国的计划生育政策、独生子女问题,以及家庭结构与代际关系变动的一个良好的载体和切入点。     

The Barangay service point officers: their performance and potentials

The Strengthening BSPO (barangay service point officer) Operations project aims to strengthen the outreach structure at the BSPO level by hastening its attainment of self-sufficiency and making it more responsive to community needs and demands. It has 2 specific objectives: to provide policymakers and managers of the outreach project with a research-based assessment of current organizational procedures, practices, and factors taht hindet the effectiveness od organizations and operations at the BSPO level; and to provide Popcom's decision makers with alternative means for evolving regional and national action plans to improve BSPO operations. This discussion presents the highlights of a 3rd major project report on the "Qualitative Survey Research on BSPOs and BSPO Operations." The report covers the outcome of focus group discussions (FGDs) conducted in 3 selected regions, with resondents consisting of BSPOs, fulltime outreach workers (FTOWs), married couples of reproductive age (MCRA), and barangay captains. 6 priority issues were taken up in the FGDs conducted: selection and recruitment of BSPOs; taining; incentives and awards; perception of roles and functions; functional relationships of BSPOs and other workers; and BSPO associations. The FTOWs considered the following qualities when choosing BSPOs: influence in the community; accessibility to neighbors; approachability and friendliness; respectability in the community; belief in family planning; satisfaction with family planning use; and ability to motivate people. Before starting volunteer work, BSPOs are trained formally for 3 days. While BSPOs recognize the importance of their role in community development, they are hesitant to accept too many tasks. They perceive the replenishment of contraceptive supply to be their primary function. Record keeping, home visits, information dissemination, and motivation are considered secondary. Popcom regional offices have incentive programs meant to cover all BSPOs. There also are incentives for outstanding BSPO performances. The available incentives are not always enough. Some BSPOs experience strained working relationshiops with workers of other agencies. Coordination among the various groups is limited. Experience has shown that the performance of BSPOs in general has not come up to the program's expectations because of improper recruitment practices, inaccurate communication of roles and functions, poor trining, inadequate incentives, and lack of coordination.     

An analysis of major proximate determinants of our fertility]

The sample survey of fertility, in Shanghai city and Shanxi and Hebei provinces of China in 1985, provided plentiful data about fertility, marriage, contraceptive usage and breastfeeding in terms of The World Fertility Survey Model. The data, along with Bongaarts' model, was utilized to analyze the relation between several proximate determinants and fertility changes. When comparing these three geographic areas, the largest difference was breastfeeding and the smallest one was non- contraceptive usage. It was very different from the results of The World Fertility Survey in developing countries in 1977. The difference of marriage indexes among three areas was close to that of breastfeeding; but for the effects on induction of fertility, marriage index surpassed breastfeeding. There were two models showing effective efficacy on fertility decline. One was the Shanghai model, in which much more effect came from marriage delay, accounting for 71%; another was the Hebei model, induction of fertility was caused by contraceptive usage, about 53%. Both indicated that the major factor affecting fertility decline was the family planning program. Otherwise, it seemed to indicate that different factors such as social, economic development indirectly decreased fertility through family planning programs.     

A preliminary analysis of the high birth rate in India]

The author first provides some basic demographic data for India and points out that the current annual rate of population growth of 2.45 percent is slightly higher than the annual increase in food production. Problems in the areas of employment, education, housing, and transportation, as well as the general problem of poverty, are seen as a consequence of this imbalance. The lack of success of the national family planning program is attributed primarily to the failure to achieve a satisfactory rate of economic growth. Contributory factors include early marriage, the low status of women, the desire for large families, and administrative problems associated with the family planning program.     

Thinking about several problems of the research of our family planning strategy]

On the basis of 1982 census data, it is estimated that from 1987-1997 13 million women will enter the age of marriage and child-bearing each year. The tasks of keeping the population size around 1.2 billion by the year 2000 is arduous. Great efforts have to be made to continue encouraging one child/couple, and to pursue the current plans and policies and maintain strict control over fertility. Keeping population growth in pace with economic growth, environment, ecological balance, availability of per capita resources, education programs, employment capability, health services, maternal and child care, social welfare and social security should be a component of the long term development strategy of the country. Family planning is a comprehensive program which involves long cycles and complicated factors, viewpoints of expediency in guiding policy and program formulation for short term benefits are inappropriate. The emphasis of family planning program strategy should be placed on the rural areas where the majority of population reside. Specifically, the major aspects of strategic thrusts should be the linkage between policy implementation and reception, between family planning publicity and changes of ideation on fertility; the integrated urban and rural program management relating to migration and differentiation of policy towards minority population and areas in different economic development stages. In order to achieve the above strategies, several measures are proposed. (1) strengthening family planning program and organization structure; (2) providing information on population and contraception; (3) establishing family planning program network for infiltration effects; (4) using government financing, taxation, loan, social welfare and penalty to regulate fertility motivations; (5) improving the system of target allocation and data reporting to facilitate program implementation; (6) strengthening population projection and policy research; (7) and strengthening training of family planning personnel to improve program efficiency.     

Withdrawal in Pakistan: new insight into an old method

Although family planning programs pay almost no attention to the validity of coitus interruptus (withdrawal), it is a traditional method of family planning widely used to regulate fertility in Pakistan. Large-scale quantitative studies conducted in recent years in Pakistan by the Population Council have indicated that withdrawal is the most popular temporary method of fertility regulation in the country, second among all methods only to female sterilization. Pakistani couples use withdrawal mainly because they believe that modern methods are unsafe for women and unreliable. They have some fears and misconceptions about modern methods. The method may work well in Pakistan also because users seem to feel that they own it. Withdrawal is therefore a reasonable option given Pakistanis' beliefs and circumstances. Those who use withdrawal in Pakistan practice the technique with considerable efficacy and tend to continue using it. Furthermore, couples which use withdrawal have discussed their family planning preferences and decided together to use the method. However, in order to improve the use of modern methods of contraception, information provision, counseling, and interpersonal communication must be improved.     

婚姻形式与男孩偏好:对中国农村三个县的考察

应用在招赘婚姻高度流行区、中度流行区和低度流行区的调查数据 ,本文研究了严格生育控制下婚姻形式以及个人、家庭和社会因素对男孩偏好的影响及其区域差异。研究发现 ,嫁娶婚姻的生育行为有明显的男孩偏好倾向 ,而招赘婚姻的生育行为则不存在性别偏好 ;男孩偏好存在显著的区域差异 ,招赘婚姻的流行显著降低了当地的男孩偏好水平。研究结果为政府在农村降低男孩偏好水平、稳定低生育率提供了新的思路和途径     

Family planning and fecundity

Abstract A computerized probability model of family-building, FERMOD, is described and then utilized in an investigation of relations between family planning and fecundity as applying to white couples of the contemporary United States. Models of this type that formulate reproductive performance as a stochastic process permit one to explore relations that are not directly observable and in this manner to secure at least partial answers to questions not subject to investigation by survey research alone. Two main questions are addressed concerning the dependence of family planning success upon fecundity: (1) How quickly does spacing control deteriorate when natural fecundability is taken at progressively lower values or when the risk of pregnancy wastage is set at progressively higher values? (2) What is the distribution of unsought births among couples of average fecundity when they practise contraception with specified effectiveness and have stipulated spacing and family size goals?