The transition to lower fertility in the West Bank and Gaza Strip: evidence from recent surveys

Using recent data from three national-level surveys conducted in 1995, 2000, and 2004, we provide evidence that Palestinian fertility rates in the West Bank and Gaza Strip, historically among the highest in the world, began to slow especially in the West Bank, but stalled in Gaza during the recent Intifada. The TFR in the early 2000s was 4.6 per woman, down from 6.2 a decade earlier. However, most of the decline in Gaza’s fertility appears to have taken place during the early 1990s, before the onset of the second Intifada. In Gaza, the TFR decreased from 7.4 to 5.7 during the 1990s, but changed only slightly to 5.6 during the second Intifada period. Surprisingly, contraceptive prevalence has not changed during these years, and the transition to lower fertility was mainly due to changes in nuptiality. Demand for children remains high, although there is evidence of unmet need for contraception. The continuing conflict and worsening economic situation provide clues to the persistence of high fertility among Palestinian women.

已婚流动育龄妇女计生公共服务现状与需求满意度——基于在江苏部分城市进行的问卷调查

通过对苏州等城市部分已婚流动育龄妇女进行的问卷调查,考察了江苏已婚流动育龄妇女群体接受计划生育公共服务的现状、需求及其满意度。调查发现,已婚流动育龄妇女对人口计生部门的工作认可程度较高,但为其提供的计生公共服务中还存在着管理机构建设滞后、经费投入不足、计生服务供给不能满足需要、管理客体缺乏生殖健康意识等问题,据此提出构建以政府为主、多元参与的流动人口计生公共服务供给模式,增加财政投入,提高流动人口计生公共服务质量等政策建议。     

Estimating optimal expenditures on family planning in developing economies

This paper develops an analytical model of the effect of family planningexpenditures on per capita income. The perspective is that of constrained optimization: a predetermined level of overall development resources is to be allocated to family planning programs and alternative uses in the form of expansion of the generalized capital stock (plant and machinery, education and training, and social infrastructure). The principal functions of the model are power forms, so that an explicit solution may be obtained for the optimal ratio of family planning expenditures to overall development resources. Important insights into the nature of this policy question are derived from consideration of the formula. In addition, tentative numerical estimates of the optimal ratio are presented for several developing economies. These estimates suggest that quite a substantial proportion of overall development resources should be allocated to family planning programs in most developing nations. The paper is concluded with a brief evaluation of the advantages and disadvantages of the optimization approach to population policy issues.     

Restrictive abortion laws, antiabortion attitudes and women’s contraceptive use

This study empirically examines the public and social policy question: Do state restrictive abortion laws affect the likelihood that women use more highly effective contraceptive methods? Using contraceptive use data from the Behavioral Risk Factor Surveillance System 2002 survey, the empirical results show that Medicaid Funding Restrictions, Informed Consent Laws, and Two-Visit Laws have no significant impact on adult women’s (ages 18-44, 18-24, 25-34, 35-44) use of highly effective contraceptive methods. A state’s antiabortion attitudes, which likely contribute to the enactment of restrictive abortion laws in a state, are a major factor in inducing greater use of highly effective contraceptive methods by adult women at-risk of an unintended pregnancy. The empirical findings remain robust for various population subgroups of adult women (i.e., married, single, employed, unemployed, with children, no children and college educated).     

Does it matter how you ask? Question wording and males’ reporting of contraceptive use at last sex

This paper reports results from a unique experiment conducted in the 2002 National Survey of Family Growth (NSFG) to gauge the effect of question format on men’s reports of contraceptive use at last sexual intercourse. Respondents received separate questions about their own and their partners’ contraceptive use or one combined question about either partner’s contraceptive use. We examine whether receiving separate questions, as opposed to one combined question, is related to higher reports of using any contraceptive method, specific methods, female methods in addition to male methods, and the number of methods reported. We find that reports of any contraceptive use at last sex and use of the most common methods, condoms and the pill, were stable across question formats. However, we find significantly higher reports of withdrawal, combining male and female methods, and multiple method use among men who received the separate-question format. We also find that characteristics of the sexual experience in question condition the effect of question format on men’s reports.     

Contraception provision in the postpartum period: Knowledge,views and practices of midwives

BackgroundWomen are susceptible to unintended pregnancies in the first year after giving birth, particularly as consideration of contraception may be a low priority during this time. Discussing and providing contraception before women leave hospital after giving birth may prevent rapid repeat pregnancy and its associated risks. Midwives are well placed to assist with contraceptive decision-making and provision; however, this is not routinely undertaken by midwives in the Australian hospital setting and little is known regarding their views and experiences in relation to contraception.MethodsAn anonymous survey was conducted with midwives at two urban hospitals in New South Wales to better understand their contraceptive knowledge, views and practices regarding midwifery-led contraception provision in the postpartum period.FindingsThe survey was completed by 128 midwives. Most agreed that information about contraception provided in the postpartum period is valuable to women, although their knowledge about different methods was variable. The majority (88%) believed that midwives have a role in providing contraceptive information, and 79% reported currently providing contraceptive counselling. However, only 14% had received formal training in this area.ConclusionFindings demonstrate that most midwives provide some contraception information and believe this is an important part of a midwife’s role. Yet most have not undertaken formal training in contraception. Additional research is needed to explore the content and quality of midwives’ contraception discussions with women. Training midwives in contraceptive counselling would ensure women receive accurate information about available options. Upskilling midwives in contraception provision may increase postpartum uptake and reduce rapid repeat pregnancies.     

Factors influencing college women's contraceptive behavior: An application of the integrative model of behavioral prediction

Objective: This study investigated variables within the Integrative Model of Behavioral Prediction (IMBP) as well as differences across socioeconomic status (SES) levels within the context of inconsistent contraceptive use among college women. Participants: A nonprobability sample of 515 female college students completed an Internet-based survey between November 2014 and February 2015. Methods: Respondents were asked about their contraception use, knowledge and information sources, demographic information, and IMBP factors, including attitudes, norms, and perceived behavioral control (PBC). Results: While overall attitudes, norms, PBC, and intentions for contraceptive use were high, only 46.8% of women used contraception consistently. Data also revealed only moderate levels of knowledge about contraception. While there were no differences across SES levels for attitudes, PBC, norms or knowledge, SES levels did differ in sources used to acquire contraceptive information. Conclusions: This study highlights the need to consider where college women acquire contraceptive information which is associated with SES.     

藏区农牧民生殖健康服务现状考察——基于对西藏昌都三县的实地调研

通过对国家计生委＂大香项目＂西藏昌都地区3个试点县农牧民生殖健康服务提供现状的实地调查发现,当地政府对生殖健康服务较为重视,生殖健康服务水平比以往有了较大程度的提高,但农牧民避孕节育措施的可及性等指标与目标要求还存在着一定差距,规范化服务的提供尚有改进的空间。     

Sexuality,Family Planning and Religion in Papua New Guinea: Reproductive Governance and Catholicism in the Lihir Islands

This paper explores the complex and dynamic relationship between religion, sexuality and health in the particular context of the Lihir Islands in Papua New Guinea. Through the teachings of Catholicism in Lihir, a version of human sexuality and relationships is promoted that assumes lifelong monogamy, heterosexuality and restraint of sexual desire to ensure safe reproduction and sexuality. Techniques of governance shape reproductive practices in accord with this moral regime. This paper seeks to analyse how Lihirians manage the gap between this idealised model for human sexuality, and their everyday lives. I argue that while Catholicism shapes the moral regime, Lihirians exercise their moral agency, strategically responding to the particular circumstances of their lives in making reproductive decisions.     

Effect of Pregnancy Intention on Child Well-Being and Development: Combining Retrospective Reports of Attitude and Contraceptive use

Prior research has documented a relationship between unintended pregnancy and negative consequences for infants and children. Much of this research is based on retrospective reports of intention, but this method has been critiqued as subject to biases in recall and reporting. Non-retrospective measures have also been employed, but these are less widely available and tend to be hindered by limited samples. Using the 1988 National Maternal and Infant Health Survey and its 1991 Longitudinal Follow-Up, a composite measure of reported pregnancy intention and birth control use is constructed to attempt to overcome some limitations of the use of retrospective reports of intention. This composite measure is compared to more conventional measures through analyses predicting the effects of pregnancy intention on child health, activity, and development. Across the different constructions of the pregnancy intention measure, children from unintended pregnancies have poorer outcomes. They are more likely to have less than excellent health, undesirable activity levels, and below median scores on a development assessment. The composite measure predicts similarly to the more conventional measures of intention, but provides an additional dimension that helps address some of the concerns about bias in retrospective reporting, while maintaining the benefit of application in existing large and representative samples. Researchers and policy makers need to continue their concern about the effects of unintended pregnancies, and need widely available measures to understand determinants, consequences, and prevention strategies.