知情选择对人工流产影响的验证

利用固定效应模型对1988—2001年全国计划生育／生殖健康调查数据进行了再次分析,以量化考察知情选择政策对中国已婚育龄妇女人工流产行为的影响。研究发现,知情选择与已婚育龄妇女人工流产可能性的降低之间呈现一定的因果关联。知情选择导致了育龄妇女人工流产的可能性降低,并在各个孩次上都有明显的体现。     

中国已婚育龄人口避孕行为的转变:1988～2001年

文章利用中国1988年和2001年生殖/节育调查数据,运用多元Logit模型,深入分析了此期间已婚育龄人口避孕选择模式的变化、区域差异及其决定因素。结果表明,在1988~2001年间,避孕选择始终是以男女性绝育和宫内节育器为主,已婚育龄人口文化程度越高,选择宫内节育器的可能性越大,反之选择男女性绝育的可能性大;农村选择男女性绝育的可能性增大,城镇选择宫内节育器的可能性增大;选择避孕套的可能性增大;东、中、西部的变化趋势一致,但幅度差异显著。这与中国育龄人口的避孕节育意愿有较大的趋同性和稳定性,其差异很可能与计划生育服务质量有关。     

论“知情选择”的法律涵义和实施

“知情选择”是群众计划生育权利的组成部分。教育群众在知情基础上实现科学选择避孕措施 ,是实现计划生育工作方法和思路转变的新途径。是时代对计划生育管理服务的新要求     

避孕“中国模式”解读

近三十年来，人口计生工作成就为世界所瞩目。其中，避孕节育作为计划生育成功的重要技术路径，对每位已婚育龄个体而言，已成为她／他们生命历程中无法回避的社会现实。尽管国家在20世纪80年代初大规模推广长效医控型避孕措施的工作方法有待商榷，     

避孕措施的知情选择:中国计划生育工作思路的探讨

背景 国际社会对于生育健康的广泛关注的核心问题之一是避孕措施的知情选择。避孕措施的知情选择是西方国家提出的生育健康项目与传统的计划生育项目的一个主要区别,是夫妇的生育权利的一个重要方面。它表明夫妇有权利和能够对避孕措施进行选择,而计划生育部门应保证夫妇能够得到各种安全有效的方法。避孕措施的知情选择在我国的实践已经开始,它展示了计划生育工作的一种新的方向。那么避孕措施的知情选择的意义是什么?在我国开展试点的状况与效果如何?对我国计划生育工作思路的调整有何启示?本刊特组织此次论坛,邀请有关专家学者就以上问题发表见解,共同探讨未来中国计划生育工作的发展方向。     

实施知情选择

近年来 ,湖北省潜江市切实转变工作方法 ,以人为本 ,以育龄群众为中心 ,大力开展优质服务 ,积极推行避孕方法知情选择 ,使育龄群众主动选择适合自己的避孕节育方法 ,从而有力地促进了计生工作质量的提高。１ .搞好宣传服务 ,动员群众主动参与知情选择。搞好宣传服务是实行知情选择的关键。他们每年都要在育龄群众中展开问卷调查 ,了解不同人群对避孕节育的需求 ,提供有针对性、实用性和可接受性的宣传和咨询服务。市电台、电视台、《潜江报》定期开办知情选择知识专题节目 ,乡、村利用生殖健康 /计划生育教育室进行宣传 ,在村以上生殖健康 /…     

知情选择避孕措施和计划生育健康教育

由于人群生殖健康知识缺乏及行政制约的影响,尚有相当数量的已婚育龄夫妇不能知己知彼地、自由地选择避孕措施,限制了药具的充分利用,影响了生殖健康的质量。为此我区从1993年开始,一手抓联合社区力量,加强计划生育健康教育,保障生殖健康,另一手抓知情选择避孕措施的试点,探索深化计划生育的新路子。 截止1995年底,全区共有52个单位,13862对夫妇采用了知情选择避孕措施,基层干部都比较满意。本文根据我区的做法,作一分析讨论。 1 步骤和方法 1.1 开发领导,统一思想。明确计划生育是做人的工作,为育龄人群提供生殖健康终生服务、提高其知识水平和自我保健能力是深化计划生育改革的方向。1.2联合社区力量,包括卫生、教育、文化、广播、电视、民政、计生协、工、团、妇等部门,共同参与计划生育健康教育,并以联席会议研讨工作。1.3区、镇、村、企业建立领导小组并确定负责人,指导社区开展工作。1.4建立咨询服务基地。在试点基础上,1994年区人民政府发文建立区、镇、村、企业的生殖卫生保健服务中心、服务站,并规定职责。截止1995年底,借用初级卫生保健网络,全区已建立区生殖卫生保健服务中心1所,镇生殖卫生保健服务中心18所,村生殖卫生保健服务站262所,企业生殖卫生保健服务站51所。1.5分层次培训骨     

对知情选择避孕方法的思考与实践

对知情选择避孕方法的思者与实践杨立舫育龄群众知情选择避孕方法（以下简称知情选择）是目前国际上所普遍倡导的。近两三年来，江苏省按照国家计生委的有关要求，在苏州、南通、常州市有关县（市）的６个乡镇开展了知情选择的工作，取得了较好效果。本文结合这６个乡镇的...     

积极开展知情选择

知情选择的全称为避孕措施知情选择 ,其基本内涵是通过广泛的宣传和咨询 ,将各种避孕方法和相关知识介绍给群众 ,在群众“知”多方面“情”的基础上 ,自愿选择适合自身特点的避孕节育措施。根据国家计生委的有关要求 ,为配合辽宁省计生委提出的在全省普遍开展知情选择的思路 ,我们对全省农村开展知情选择的情况进行了专题调研 ,主要结果如下 :一、辽宁省农村开展知情选择的基本情况（一）开展概况１９８８年知情选择在辽宁省大连市普遍推开 ,１９９３年国家计生委正式确定大连市金州区为国家知情选择的试点县（区）。１９９５年省计生委确定…     

避孕方法知情选择影响因素的干预分层解析

国际经验表明,全球范围内的避孕方法知情选择在现实与理想之间仍存在一定的差距。文章按照干预实施的需要,运用文献回顾和数据资料从个体/社区、服务提供以及政策措施三个层面剖析我国开展避孕方法知情选择的影响因素。结果显示:首先,我国的相关法律、法规和政策对避孕方法知情选择既有有利的因素也有不利的因素;第二,在服务提供层面,管理人员对避孕方法知情选择的认识有误或认识不足严重阻碍了当地知情选择的开展;第三,社区/家庭等个人密切接触的小环境容易被忽视,这一层次的因素应予以充分重视和足够关注。基于以上认识,提出了开展避孕方法知情选择的干预策略。     

The Persistence of Outmoded Contraceptive Regimes: The Cases of Mexico and Brazil

Two of the most striking characteristics of contraceptive practice in the world today are the wide variation in patterns of use across countries and the tendency of the distribution of use by method to persist or narrow, even as new methods become available. The argument advanced in this article is that the disposition to commit to a reduced range of methods results from positive feedback in the process of contraceptive choice, and follows the logic of path dependence. The positive feedback derives, in large part, from social interaction among both the providers and the users of contraceptive methods. The persistence of outmoded contraceptive regimes is illustrated with the experience of Mexico and Brazil. In each case, it is argued that the conditions, events, and policies in the early stage of the adoption process have had a determinant bearing on the contraceptive practice prevailing in the late 1990s.     

Non-Heterosexuality,Relationships, and Young Women’s Contraceptive Behavior

Non-heterosexual young women have a higher rate of unintended pregnancy than their heterosexual peers, but their fertility behaviors are understudied. We use longitudinal data from the Relationship Dynamics and Social Life study to investigate mechanisms contributing to non-heterosexual women’s higher pregnancy risk. These data include weekly reports of relationships, sex, and contraceptive use over 30 months. We compare the relationships and fertility behaviors of three groups: exclusively heterosexual (consistent heterosexual behavior, identity, and attraction); mostly heterosexual (heterosexual identity with same-sex behavior and/or same-sex attraction); and LGBTQ (any non-heterosexual identity). We find that mostly heterosexual and LGBTQ women behave differently from exclusively heterosexual women in ways likely to elevate their risk of unintended pregnancy: more distinct partners during the study period, more sexual intercourse with men, less frequent contraceptive use, less use of a dual method (condom plus hormonal method), and more gaps in contraceptive coverage. Mostly heterosexual women resemble LGBTQ women in their contraceptive behavior but have significantly more intercourse with men, which may increase their pregnancy risk relative to both LGBTQ and exclusively heterosexual women. We conclude by considering implications for LGBTQ health and the measurement of sexual minority populations.     

Contraceptive Method Choice Among Youth in the United States: The Importance of Relationship Context

We examine the relationship characteristics associated with contraceptive method choice within young people’s nonmarital sexual relationships, using data from retrospective relationship histories available in the third wave (2001–2002) of the National Longitudinal Study of Adolescent Health. Data-reduction techniques produce a detailed multidimensional characterization of relationship commitment for nonmarital sexual relationships. We then use multilevel analysis to estimate associations between two key relationship characteristics—relationship commitment and couple heterogamy—and the type of contraceptive method used at last sexual intercourse within each relationship. Results indicate that for a given individual, contraceptive method choice varies across relationships as a function of these characteristics, even after we account for important individual and family characteristics and prior relationship experiences.     

Contraceptive attitude-behavior consistency in adolescence

Thornburg (1973) suggests that adolescents experience a high level of value-behavior inconsistency compared to individuals in other stages of the lifespan due to engaging in peer-oriented behavioral realms that are contrary to values shared with the parental family. Extending Thornburg's value-behavior inconsistency model to encompass contraceptive attitudes and behavior, it is predicted that contraceptive attitude-behavior inconsistency is prevalent among sexually-active adolescents, and that inconsistency would be greatest when parental and peer contraceptive attitudes are perceived to be incongruent. Analysis of a sample of 167 sexually-active adolescent females ages 13-to-18 indicates that general contraceptive attitudes are consistent with contraceptive use, whereas attitudes toward specific contraceptive methods are unrelated to contraceptive behavior. The data lend support to the predictions of Thornburg's model in that contraceptive attitude-behavior inconsistency is greatest under peer favorable/parent unfavorable and peer unfavorable/parent favorable contraceptive attitude conditions.This research was supported by a grant from the United States Department of Agriculture, Agricultural Experiment Station, University of Arizona. The data for the study were gathered in 1978 and 1979.     

我国已婚育龄人群避孕水平及避孕方法使用趋势

利用中国20世纪60年代到2004年的全国计划生育调查数据,深入分析我国已婚育龄人群避孕水平及避孕方法的使用趋势。结果表明,我国一直是全球总避孕水平最高的国家,避孕方法以长效措施为主。90年代后,主要避孕方法中宫内节育器现用率逐年上升,女性绝育逐年小幅下降,男性绝育逐年明显下降,避孕套现用率逐年递增,口服避孕药、外用避孕药和其他避孕方法呈逐年下降趋势;且避孕方法的选择存在省市、城乡差异。     

Family Planning and Child Health Care: Effect of the Peruvian Programa de Salud Reproductiva y Planificación Familiar, 1996–2000

Our study estimates the effects of exposure to a family planning program which promoted surgical contraception for the first time in Peru on women's use of birth control methods and their children's health. While a broad program, the Programa de Salud Reproductiva y Planificación Familiar forced many indigenous women to undergo sterilization. We compare provinces affected by the program earlier with provinces affected later, before and after the policy. Overall, the results indicate that women in treated areas were more likely to use both temporary and permanent contraceptive methods and their children were less likely to die within their first year of life, partly due to longer breastfeeding. However, we observe heterogeneity by ethnicity. In treated provinces, nonindigenous children benefited from the policy regardless of their mothers’ choice of contraceptive method, while there were few positive impacts for indigenous children whose mothers underwent sterilization. This suggests that coercive or aggressively implemented family planning programs may not confer health benefits on children.     

Decision-Making Patterns and Contraceptive Use: Evidence from Uganda

Literature on the effect of decision-making patterns on contraceptive use often does not (1) distinguish between women participating in decisions and controlling them, and (2) account for effects of common decision-making patterns within the community. In Uganda where high fertility persists, both of these factors may be relevant to adoption of contraception. We used data from the 1995/96 Negotiating Reproductive Outcomes (NRO) Study which surveyed 1,750 women in 78 communities located in two districts in Uganda. We assessed the effects of individual and community factors on the adoption of modern contraceptive methods using multilevel logistic regression. We included measures of decision-making patterns at both the individual and community levels that distinguished husband-dominated, joint, and wife-dominated decision-making patterns. Contraceptive use is 29% more likely in communities where women more commonly have unilateral control over household decisions. This strong effect of normative decision-making patterns within the community is net of individual education and community education, both of which had strong and significant effects. Less traditional gender roles as measured by normative decision-making patterns seem to support more innovative fertility behavior. Community decision-making patterns matter importantly for contraceptive use in this low contraceptive prevalence setting and need to be assessed elsewhere. Further, women’s influence is inadequately measured where joint decision-making and wife-dominated decision-making are considered together.     

Adolescent Contraceptive Method Choices

This article analyzes determinants of contraceptive method choices among adolescent women in the United States. By using data from the 1982 National Survey of Family Growth, we examined factors that differentiate users of various methods early in the sexual careers of teenaged women. We find that patterns of method choice not only vary by race and region within the United States but also change over the teenager's life course. In addition, among teenagers who did not use a method at first sex, the likelihood of adopting a method soon thereafter was low for both whites and blacks and was unaffected by social structural characteristics.