Femininity and family planning

Kosnik, Anthony, William Carroll, Agnes Cunningham, Ronald Modras and James Schulte. Human Sexuality: New Directions in American Catholic Thought. New York, N. Y.: Paulist Press, 1977. 320 pages. $8.50.

Lloyd, Robin. For Money or Love: Boy Prostitution in America. Introduction by Birch Bayh. New York: Vanguard Press, 1976. 236 pages. $8.95.

Sagarin, Edward. “Prison Homosexuality and Its Effect on Post‐Prison Sexual Behavior.” Psychiatry, August 1976, 39 (3), 245–257.     

Women's status and family planning in Haiti

"The paper argues that women's status in Haiti is a factor favorable to the spread of modern contraception and a potential rapid demographic transition from high to low fertility. After briefly reviewing recent theories on the determining of fertility declines, the paper considers women's status in Haiti. It discusses family patterns, conjugal unions, and economic activities. Finally, it reviews current patterns of contraceptive use and considers how these are related to various aspects of women's status."     

The variation in family background amongst young homeless shelter users in Denmark

This article analyses variation in the family background of young homeless people in a cohort of young Danes. The study is based on administrative data for individuals who were 18 years old in 2007 and their parents. Homelessness is measured by shelter use over a five-year period. Data also cover education, employment, mental illness, substance abuse problems and placement outside home in childhood for the young persons, and education, employment, civil status, mental illness and substance abuse problems for their parents. A cluster analysis identifies two groups, each comprising half of the young shelter users. In the first group, social marginalisation is transmitted between generations, as most parents have low education and mental illness or substance abuse problems, and are unemployed. In contrast, the young people in the second group come from wider socioeconomic backgrounds, with few of their parents having mental illness or substance abuse problems. These young people develop psychosocial problems and become homeless without strong predictors from their family background. Amongst the young shelter users from families with severe social problems a higher share are in the Not in Education, Employment or Training group. They also have more shelter stays, compared to young shelter users from families with fewer social problems.     

Local and transnational care relations: relatedness and family practice among au pairs in Denmark

An increasing number of young women from the Global South have become au pairs in the Global North since the turn of the millennium. Through ethnographic analysis of three cases of au pairing in Denmark, involving Filipina and Caribbean women, this article discusses the nature of the local as well as transnational family relations in which these women are embedded as au pairs, and the opportunities and restraints that they present. We use anthropological theory to conceptualize family and kinship in terms of notions and practices of relatedness. This offers a useful framework for elucidating the different moral and contractual obligations and expectations associated with these varying family relations, the power asymmetries with which they are linked, and the agency that the au pairs display as they seek to position themselves in the most favourable way in relation to the multi‐directional ties in which they are involved.     

Maternal and child health and family planning services in the Sudan

Given the high rates of infant and maternal mortalty, the prevalence of infectious diseases, poor nutritional status among women and children, and numerous endemic diseases such as malaria and bilharzia, maternal-child health serivces have been given a high priority in the Sudan. In reality, however, this area has not received adequate attention within the primary health care system in terms of management, service provision, and training. Major obstacles to effective maternal-child health services include: 1) the lack of involvement of community health workers, the main providers of other primary health care services in the Sudan, in the area; 2) the clinical orientation of physicians, which mitigates against attention to the promotive and preventive components of health care; 3) a lack of standardization of medical records or data collection routines, which hinders program monitoring; and 4) the failure to integrate related national programs such as immunization into a comprehensive maternal-child health program. In addition, there are administrative and organizational obstacles, such as the lack of institutionalization of maternal-child health services within the Ministry of Health, inadequate managerial capabilities, an absence of guidelines for service delivery at the regional and provincial levels, delays in the procurement of equipment and supplies, a widely dispersed population, and transportation difficulties. Family planning, too, is supposed to be the responsibility of all primary health care workers in the Sudan. However, current training programs for physicians, nurses, village midwives, and community health workers do not prepare them to fulfill this role. Development of an official population policy in the Sudan is recommended to ameliorate some of these problems.     

The role of the clinician in natural family planning

Despite skepticism on the part of the health care delivery system, increasing numbers of women and couples are relying on natural family planning methods to avoid or achieve pregnancy. Most clients require 2-4 cycles to become familiar with the delineation of the fertile phase. Both the ovulation and the sympto-thermal methods are considered to have a method effectiveness of at least 98%. Teaching-related unplanned pregnancies fall below 5%. Use of the Billings ovulation method requires the couple to abstain from intercourse from the beginning of mucus until the 4th day after peak. The sympto-thermal method is preferred by those desiring a multiple-index approach. 75-80% of users of this method can detect cervical softening and dilatation, and 50% are aware of the change of position of the cervix. Knowledge of mucus buildup patterns can be expecially important for adolescents, lactating women, and premenopausal women in helping them to determine whether cycles are ovulatory. Instruction in interpretation of the mucus cycle is further advised in cases of infertility. Unwillingness of the partners to practice it constitutes the only contraindication to natural family planning. However, couples are advised to wait for the postovulatory infertile phase of the cycle to have intercourse in cases where prgnancy would pose a serious threat to the life of the mother or fetus. Although some groups recommend the use of a barrier method rather than abstinence during fertile periods, this practice makes mucus recognition more difficult and impedes confidence in the method. Attainment of couple autonomy in natural family planning involves 2 phases: 1) correct recognition of the signs of fertility and 2) comfort with periodic asbsinence. Successful autonomy is reflected in the high continuation rates found in programs that offer adequate counseling support.     

Population and family planning in developing countries: the employer's role

The overall population problem of the world is discussed briefly. The author asserts that rapid population growth has serious social and political implications and imposes serious restraints on economic progress. It is also linked to problems of urbanization. Family planning is a way out. The state alone is not enough to make family planning successful, it must be supported by the different segments of society. Employers have a major social responsibility in this respect. After this general introduction, and the assertion of the basic role of the employer in family planning programs, the author deals with the specific situation in India in terms of 1) its population problem, 2) progress and impact of the Indian family planning program, and 3) the role of employers in the promotion of family planning in India; a detailed section is devoted to the family planning centers of the Tata group of companies (Tata textile units, chemicals, iron and steel, engineering and locomotive, etc.). The author enumerates the measures to promote effective participation by employers, which include 1) an organized framework, 2) assistance to employers, and 3) removal of disincentives. The author concludes by saying that the efforts of employers to limit population growth need to be supplemented by international cooperation and action.     

Community and individual acceptance: family planning services in the Sudan

The Sudan Community-Based Health Project, initiated by the University of Khartoum in cooperation with the Ministry of Health in 1980, sought to test the proposition that government-trained village midwives could provide maternal-child health and birth spacing services in addition to their ongoing obstetrical duties. The project area encompassed 92,000 people in 93 villages. The 120 midwives serving the project area received training in 4 interventions -- oral rehydration therapy, maternal and child nutrition, immunization, and birth spacing -- and introduced these services by means of 3 rounds of household visits over a 5-month period. Comparison of pre- and post-intervention survey data indicates that village midwives can indeed be used successfully to promote not only contraceptive use, but also health attitudes and practices that are positively associated with fertility regulation. Between the 2 surveys, the percentage of women who ever used contraception increased from 22% to 28%, while the percentage of current users rose from 10% to 13%. Parity was significantly related to current use; each child born multiplied the likelihood of contraceptive acceptance (by a factor of 0.76 in the post-intervention sample). Maternal education was the socioeconomic variable that most enhanced receptivity to contraceptive acceptance after the project's interventions. In terms of community-level variables, village location along the Nile and proximity to a paved road were significant correlates of contraceptive use. When variables related to the project itself were analyzed, women with vaccinated children were found to be twice as likely to contracept as those with nonvaccinated children and women who believed breast feeding should be continued during diarrhea episodes were 1.5 times more likely to use birth spacing than those who did not. Although midwives did not specifically emphasize contraceptive use, it appears women who were encouraged by midwives to take positive steps in the area of child health were also likely to become more innovative in terms of fertility regulation.     

Training x Trainee Interactions in a family planning intervention

This study investigated the effects of introducing a family planning counseling model at clinics of Peru's Ministry of Health. Providers trained in the model presented greater quality of care and longer counseling sessions than did controls. The main effects, however, were misleading. Nearly all of the quality improvements were contributed by 37% of the trained providers; they had already been better performers at the pretest and complied with the new counseling model's requirement of job aid use at the posttest. The recognition that a majority of trained providers did not profit from training posed a challenge that led to improvements in the model. Training x Trainee Interactions should be explored in evaluations.     

Danish home care policy and the family: implications for the United States

This paper provides an overview of reforms in Danish long-term care initiated in the early 1980s, describes the relationship between elder care in Denmark and the family, and considers implications for U.S. policy. The success of Denmark's community-based experimentation with new models of home care and housing for the elderly resulted in a national decision to eliminate new construction of nursing homes and increase access to publicly funded home care. Lingering concern that the provision of paid assistance for the elderly could undermine family structure is allayed by the findings of a recent survey: Three-fourths of the elderly report seeing their children on a weekly or more frequent basis. Findings from the Danish experience provide evidence that community-based services can aid family caregivers, enable the frail elderly to live in the setting of their choice, and be cost-effective from a public policy perspective.     

Migrant-nonmigrant differentials in socioeconomic status,fertility and family planning in Nepal

This study identifies the socioeconomic characterisitics of immigrants in Nepal, their fertility, and the incidence of family planning. These characterisitics are contrasted with the receiving or nonmigrant population and inferences drawn regarding the probable social and demographic impact immigrants may have on the "receiving" population. Demographic surveys were conducted annually from 1975 through 1978 in the Hills and Terai by the research and evaluation unit of the Family Planning/Maternal Child Health (FR/MCH) Project. In each of these geographic areas, all districts were matched on a set of social and demographic characteristics. 2 districts were then selected from each area on the basis of their similarity to each other. The sample design for all districts involved selection of panchayats (a political unit roughly equivalent to a country) and their wards (villages) on the basis of a procedure which refers to a selection of units based upon probabilities proportional to size of the population of the units. Currently married women aged 15-44 in all households of the secondary sampling units, i.e., wards, were interviewed. Both migrant women and their husbands had a higher level of educational attainment than nonmigrant women and their husbands. Indian migrants had higher proportions in the largest landholding groups than nonmigrant and lower proportions who are landless. The differential was maintained among Indians who had lived in the Terai for 10 years or less as well as 11 years or more. This finding was particularly striking since Indian migrants make up 25% of the sample. Current marital fertility (as measured by age specific and total fertility rates) was highest among Indian migrants, but cumulative fertility or past reproductive performance (as measured by the mean number of children ever-born) was highest among migrants from "other districts." With the exception of the youngest age group, migrants from "other districts" have higher proportion of "ever users" and "current users" of family planning than nonmigrants or migrants from India throughout the age structure. The highest proportion for both "ever users" and "current users" was reached at ages 35-39 years. Indian migrants in contrast had the lowest proportions of "ever users" and "current users" throughout the age structure (with the exception of the age group 35-39).     

Semi‐legal family life: Pakistani couples in the borderlands of Denmark and Sweden

In 2002, the Danish government introduced new legislation on family reunification to restrict the transnational arranged marriages that were occurring among some immigrant groups. Since then, thousands of people have emigrated from Denmark to Sweden where, as citizens of the European Union, they are entitled to family reunification. In this article, I introduce the concept of semi‐legality to describe the situation whereby Pakistani transnational couples commute on a regular basis between their legal residences in Sweden and their places of work or networks of friends and family in Denmark. The married couples subjected to this mobile lifestyle are always in a process of becoming illegal, which is the consequence of ‘overstaying’ in Denmark or ‘understaying’ in Sweden. Besides its legal aspects, a semi‐legal status also has significant moral implications that not only restructure marriage patterns and family life among Pakistani immigrants but also have long‐lasting effects on the relationship between minorities and majorities in Denmark.     

The impact of an integrated family planning program in Russia

In 1995, the U.S. Agency for International Development implemented an integrated program of family planning education and services in six Russian cities to increase physicians' and women's contraceptive knowledge and change current contraceptive use. Large population-based surveys of women ages 15-44 were carried out at the beginning of project implementation (in 1996) and 3 years later in two project sites and a comparison site. Results from these surveys indicate that project activities affected women's knowledge of family planning methods, and caused women to have more favorable attitudes toward modern contraception. In addition, abortion rates decreased in project sites while remaining virtually unchanged in the comparison site. Because of uneven implementation of project interventions in the demonstration sites, however, the intervention's actual impact on abortion rates remains unclear.     

Utilizing grassroots workers in family planning programs in India: prospects and problems

In order to rapidly expand the network of delivery systems and speed up the process of acceptance of family planning messages and methods, a shift took place in the Indian family planning program from the bureaucratic "clinical" approach to the people oriented "extension" approach. As a result, there is an increasing emphasis on moving the family planning efforts closer to the grassroots level. A key methodological issue centers on the proper selection, cultural acceptability, and the effectiveness of the grassroots workers who are to be trained and through whom family planning motivational messages and methods are to be introduced. The Indian government, from time to time, has trained and utilized different groups of grassroots workers in its family planning promotional efforts. Anthropological field studies were conducted in two different regions in India to examine the potential and actual roles of two groups of grassroots workers--opinion leaders and traditional birth attendants--in the delivery of family planning services in the rural areas. These studies revealed that while the traditional birth attendants can be trained and utilized to a limited extent in promoting family planning efforts, especially to the eligible female clients, the role of the opinion leaders in such efforts is at best questionable. Based on these field studies, cultural and technical (including bureaucratic) problems in training and utilizing opinion leaders and traditional birth attendants are explored in detail. Modifications in the training program strategies are suggested to improve and expand the family planning delivery system in rural India.     

Modern family planning,sexual behavior and marriage status among women in Tanzania

"This article looks into sexual behavior and marriage status among women attending Mother and Child Health Care clinics in Tanzania. It looks into the effects of such behavior on the marriage and suggests some policy implications, especially in relation to modern family planning methods. The data which form the basis of this article were collected [in 1987] among 244 women in two urban centers in Tanzania."