Program analysis using the client oriented cost outcome system.

The client oriented cost outcome system has been under development in Pennsylvania community and hospital programs since 1972. The system builds upon the behavioral and decision data generated with or on behalf of consumers. Flexibility for local program system design is permitted if the procedures of consumer intake, review, and termination document each consumer's (a) problems, resources, and goals, (b) overall functioning level in their ordinary community, and (c) services intended and rendered as related to (a), above. While the system's primary application is in providing feedback for local program quality assurance and evaluation procedures, aggregation of data permits program planning and evaluation at county, state, and federal levels in terms of (a) client demographic or diagnostic characteristics, and (b) program service characteristics and objectives.     

Toward an assessment of the social role of rural midwives and its implication for the family planning program: an Iranian case study

An axiom of family planning programming is the importance of culturally-appropriate communicators and motivators. Traditional midwives seem ideal for this task but few studies have been done to verify this assumption by analyzing the midwife's social role as perceived by the community. 325 married women and 81 unmarried girls from a "model village" near Shiraz were interviewed by female undergraduates. 82.5% of the women are of childbearing age; 66% married before 14 years; 33% use contraception, mostly the pill, but most want large families because they expect high child mortality rates. Most of the older women are able to assist in childbirth but none, except the village's one recognized midwife, who is considered to have divine backing, will do so except in an emergency. The midwife's activities cause her to be held in low esteem by the community because 1) she has contact with a woman's sexual parts and this fact is public; 2) she has contact with vaginal excretia which are, in Islam, polluting; and 3) she is paid for her services, which labels her as a woman "without shame". The midwife is, however, widely used since women and their husbands fear the trip to the hospital and treatment by a male doctor much more than a midwife-supervised birth. The midwife in the study village had been there only 2 years and feels that she is not fully trusted. She is not consulted on birth control at all, because women expect the pill to be dispensed by doctors and consider other methods as a matter strictly between husband and wife. The midwife's role seems to complement that of the government health authorities rather than compete. The midwife's low status and circumscribed sphere of activity, the weak respect in which her advice is held and the pattern of having only 1 recognized midwife in a village at a time make the midwife a poor agent for family planning services. Her effectiveness as an agent of social change could be improved by training her in hygienic practices of childbirth and by redefining her role-relationship with the community. Studies should be done to identify the areas where traditional birth attendants are the best family planning communicators and those where that role is best left to others.     

Anticipated demographic development in Poland in the light of the new demographic projections

The authors present the results of revised population projections for Poland for 1985 based on the final results of the 1978 population census. Assumptions made in previous projections are critically reviewed, as are the population estimates on which those projections were based     

Trends in marriage and divorce in Peninsular Malaysia

Summary Median age at marriage for women has risen sharply for each of the three major ethnic groups - Malays, Chinese and Indians, in Peninsular Malaysia since 1957. The sharpest rise has been recorded for Malays and Indians, whose median age at marriage was barely over 17 in 1957. A shortage of potential husbands in the traditionally sanctioned ages contributed to the rise for Malays and Indians, but was probably not the paramount reason; average age differences between the spouses narrowed, but median age at marriage for men actually rose. During the same period, the previously extremely high divorce rates amongst Malays have fallen sharply, though wide inter-state differences remain. The sharp changes in marriage patterns reflect, and in turn are partly responsible for, far-reaching social and economic changes. They have profoundly affected fertility levels and patterns, as well as intra-familial relationships.     

The Consequences of Validated and Self-Reported Voting Measures

This paper reports on the results of validation of the self-reportedregistration status and voting behavior of respondents in the1976 and 1978 American National Election Studies. The resultsindicate about one in seven of the respondents misreported theirregistration status or voting behavior. Comparative analysesare conducted using simple regression models to see if differencesin their explanatory power arise using validated and self-reporteddependent variables. The results show that there are no majorchanges in the fundamental nature of basic relationships thathave been observed since the first surveys were conducted. Analysisof the effects of overreported participation on estimates ofthe partisan division of the vote in three sets of subnationalcontests reveals a likely "bandwagan" effect. . Portions of the data utilized in this article were made availableby the Inter-university Consortium for Political and SocialResearch. The data for the 1976 and 1978 American National ElectionStudies were originally collected by the Center for PoliticalStudies of the Institute for Social Research. The Universityof Michigan, under a grant from the National Science Foundation.Neither the original collectors of the data nor the Consortiumbear any responsibility for the analyses or interpretationspresented here. The comments of an anonymous reviewer, whichresulted in a fruitful extension of the analysis, are gratefullyacknowledged.     

Comment on 'facts and artifacts in the study of intra-uterine mortality: a reconsideration from pregnancy histories' by henri léridon(1)

Abstract Extract I have suggested that at a given birth order the probability of having a further pregnancy is greater when the last pregnancy had been spontaneously aborted than when it resulted in a birth.(2) Léridon,(3)in the course of a valuable paper on foetal wastage, presents data which, according to him, impugn my suggestion. I would like to question his claim.     

A future for the corporate planner?

Although not initiated by the event, it seems appropriate that this article is written on the tenth anniversary of the founding of The Society for Long Range Planning. It is entirely coincidental that Ansoff's book ‘Corporate Strategy’, which has evolved into the standard work on corporate planning, also appeared about a decade ago. This fortuitous coincidence has been further emphasized by the recent publication of another book from the same authority which introduces an entirely new factor into the future prospects for corporate planners. An attempt is made here to assess its implications.