Elements of Family Planning Success

It is important to examine whether youth from disadvantaged households are less likely than others to use a condom at first sex, even after correcting for shared characteristics within communities. METHODS: Baseline survey data from the Transitions to Adulthood in the Context of AIDS in South Africa study in KwaZulu-Natal were used. Random effects logistic regression assessed the relationship between poverty and 14-22-year-olds' use of condoms at first sex, correcting for shared characteristics of adolescents within each community. RESULTS: Twenty-three percent of young people had used a condom at first sex. Poor and extremely poor females had about one-third the odds of nonpoor females of using a condom at first sex, even after adjusting for community clustering; among males; however, there was no association between poverty and condom use, after adjusting for background factors and community clustering. CONCLUSIONS: The importance of community clustering of neighborhood-level characteristics differs by gender in South Africa. Poverty remains a central risk factor for HIV among young women, regardless of the surrounding context, but not among men.

In the first clip, Dr. John Stanback, Senior Research Associate for Family Health International, emphasizes the importance of offering targeted and free or subsidized services to the poorest of the poor. In the second clip, Dr. Stanback argues in favor of providing injectable contraception without prescriptions from rural drug shops.

The paradigm shift in population and development that occurred at the International Conference on Population and Development (ICPD) in Cairo, in 1994, from reduction in population growth for socio-economic progress to ensuring sexual and reproductive health and rights as a fundamental human right and as a means for improving the quality of life, has also become apparent in the Pacific. The Millennium Development Goals (MDGs) provide the current global framework for development efforts and were formally endorsed in 2000 by 189 countries, including Pacific island countries. The importance of sexual and reproductive health was not fully articulated during the formulation of the MDGs as an explicit goal. However, during the World Summit convened in 2005, world leaders endorsed the fundamental human right of "universal access to sexual and reproductive health services" _ an additional target to the MDG 5, as a result of intense lobbying by sexual and reproductive health advocates, including the Prime Minister of Tuvalu. The full integration of the MDGs into national sustainable development strategies and plans outlining an allocation of a certain percentage of the national budgets to poverty reduction is requiring a lengthy internalization and implementation process for many Pacific island countries. Part of the challenge for many of those countries has been the relevance of the poverty definition and the prevailing perception by some country leaders that "poverty of opportunity" is the more fundamental issue. Repositioning family planning as an integral development strategy for poverty reduction and as a mechanism for achieving fundamental reproductive rights needs to be acknowledged at the highest political level. (excerpt)

In Argentina adolescent pregnancy is still regarded as a public health problem or a "social epidemic". However, it is necessary to ask from which perspective and for whom it is a problem, and what type of problem. This article presents the findings of a large quantitative and qualitative study conducted in five Northern provinces and two metropolitan areas of Argentina in 2003-2004. Based on the results of a survey of adolescent mothers (n=1,645) and ten focus group discussions with adolescent girls and boys, it addresses the connections between school dropout, pregnancy and poverty, and makes recommendations on how to tailor health care and sexuality education to address local realities. The findings indicate a need to develop educational activities to promote safer sex and address gender power relations in programmes working with deprived communities. Sexuality education with a gender and rights perspective, and increasing accessibility to contraceptive methods for adolescent girls and boys is also crucial. Antenatal and post-partum care, as well as post-abortion care, should be improved for young women and viewed as opportunities for contraceptive counselling and provision. Male participation in pregnancy prevention and care also needs to be promoted. (author's)

This study examined the role of hunger and food insecurity in the sexual behaviour of female commercial sex workers in Lagos metropolis, Nigeria within the context of HIV/AIDS. In addition, the study investigated the prevalence of sexually transmitted infections (STIs) and induced abortion among the respondents. Cross-sectional survey and in-depth interview research methods were adopted to generate both quantitative and qualitative data from the respondents. Findings of the study showed that 35.0% of the respondents joined the sex industry because of poverty and lack of other means of getting daily food. While all the respondents had knowledge about the existence of HIV/AIDS, 82.0% of them identified sexual intercourse as a major route of HIV transmission. There was a significant relationship between poverty, food insecurity and consistent use of condoms by female sex workers at P less than 0.01. Specifically, only 24.7% of the respondents used condoms regularly in every sexual act. Consequently, 51.6% had previous cases of STIs. The most prevalent STI among the respondents was gonorrhea, with 76.4% prevalence among ever infected female sex workers. This was followed by syphilis with a prevalence of 21.1%. In addition, 59.1% of the sample had become pregnant while on the job and 93.1% of these pregnancies were aborted through induced abortion. In conclusion, hunger and malnutrition were the factors that pushed young women into prostitution in Nigeria and these same factors hindered them from practicing safe sex within the sex industry. Thus, it is recommended that the Nigerian government should develop programmes that will reduce hunger and food insecurity, in order to reduce rapid transmission of HIV infection in the country. (author's)

The sociocultural and demographic heterogeneity of Pacific island countries and territories, whose populations range from 6.3 million in Papua New Guinea to 1,200 people in Niue, adds to the complexity of monitoring progress towards achieving the MDGs in the Pacific. The difficulty of determining whether valid data exist for relevant indicators and the ambiguity of interpretation of certain indicators and targets within the context of very small populations poses significant challenges to monitoring progress towards the achievement of the MDGs. Furthermore, the reporting of summary statements with average figures does not adequately capture the disparities that exist across socio-economic groups, rural/urban groups or main island versus outer islands. To further complicate the issue, there is no single set of SRH indicators that would appear appropriate for the Pacific; the relatively conservative sociocultural setting poses some problems to the measurement of sexual behaviour; routine health information systems do not capture the needed community-based data; and national demographic health surveys have not been previously undertaken in many countries in the region. In addition, information on access to care is largely unavailable for the region. The status of sexual and reproductive health and prospects for achieving the MDGs, as outlined in this article, was written bearing in mind these aforementioned constraints. (excerpt)

In the late 20th century, the perspective of social and demographic research on human reproduction, sexuality and health changed as it gradually incorporated human rights, social and gender inequality issues and a broader range of crucial health dimensions related to reproduction. Concern over women's reproductive health during their various life stages - birth, infancy, childhood, adolescence, adulthood and the menopause - and incorporating men's reproductive health at several stages, was another key innovation. Research and intervention practices were also modified by the involvement of new actors in these issues and by the re-formulation, re-orientation and focussing of social and population policies on the vulnerable and excluded population groups in most countries. Redistributing responsibilities and the provision of certain services among governments, the private sector, civil society organizations, and the family and mainly individuals were novel proposals for implementing public policies and programs. The emergence of the reproductive health (RH) concept as a theoretical conceptual paradigm and as an instrumental and operative approach, has contributed decisively to the transformation of this scenario. Within this context, eradicating or reducing global poverty and promoting fundamental rights to development have emerged at the forefront of almost all current international agendas. At the national level, this problem has also become a priority issue that has led to the positing of major new challenges in both public policies and social movements, as well as in the academic context. Not only does it warn of the complexity, contradictions, tensions and conflicts in the way this issue is dealt with, it also criticizes the simplicity and fallacy underlying the conceptualization, measurement and significance of poverty. (excerpt)

Includes population figures, annual population growth rate, birth rate, death rate, total fertility rate, age specific fertility rates, life expectancy rate, infant mortality rate, mortality under age 5, sex ratio of population, urban population, secondary school enrollment, contraceptive prevalence rate, proportion of persons with disabilities, national poverty rate, human development index, population projected to 2025.

This report is one in a series that provides basic information about health, nutrition, and population (hnp) inequalities within fifty-six developing countries. The series to which the report belongs is an expanded and updated version of a set covering forty-five countries that was published in 2000. The fifty-six reports in the current series cover almost all DHS surveys undertaken during the period beginning in 1990 and ending with the date of the last survey for which data were publicly available as of June 2006. The report's contents are intended to facilitate preparation of country analyses and the development of activities to benefit poor people. To this end, the report presents data about hnp status, service use, and related matters among individuals belonging to different socio-economic classes. The principal focus is on differences among groups of individuals defined in terms of the wealth or assets of the households where they reside. The source of data is the Demographic and Health Survey (DHS) program, a large, multi-country household survey project. (excerpt)

This report is one in a series that provides basic information about health, nutrition, and population (hnp) inequalities within fifty-six developing countries. The series to which the report belongs is an expanded and updated version of a set covering forty-five countries that was published in 2000. The fifty-six reports in the current series cover almost all DHS surveys undertaken during the period beginning in 1990 and ending with the date of the last survey for which data were publicly available as of June 2006. The report's contents are intended to facilitate preparation of country analyses and the development of activities to benefit poor people. To this end, the report presents data about hnp status, service use, and related matters among individuals belonging to different socio-economic classes. The principal focus is on differences among groups of individuals defined in terms of the wealth or assets of the households where they reside. The source of data is the Demographic and Health Survey (DHS) program, a large, multi-country household survey project. (excerpt)

This report is one in a series that provides basic information about health, nutrition, and population (hnp) inequalities within fifty-six developing countries. The series to which the report belongs is an expanded and updated version of a set covering forty-five countries that was published in 2000. The fifty-six reports in the current series cover almost all DHS surveys undertaken during the period beginning in 1990 and ending with the date of the last survey for which data were publicly available as of June 2006. The report's contents are intended to facilitate preparation of country analyses and the development of activities to benefit poor people. To this end, the report presents data about hnp status, service use, and related matters among individuals belonging to different socio-economic classes. The principal focus is on differences among groups of individuals defined in terms of the wealth or assets of the households where they reside. The source of data is the Demographic and Health Survey (DHS) program, a large, multi-country household survey project. (excerpt)

This report is one in a series that provides basic information about health, nutrition, and population (hnp) inequalities within fifty-six developing countries. The series to which the report belongs is an expanded and updated version of a set covering forty-five countries that was published in 2000. The fifty-six reports in the current series cover almost all DHS surveys undertaken during the period beginning in 1990 and ending with the date of the last survey for which data were publicly available as of June 2006. The report's contents are intended to facilitate preparation of country analyses and the development of activities to benefit poor people. To this end, the report presents data about hnp status, service use, and related matters among individuals belonging to different socio-economic classes. The principal focus is on differences among groups of individuals defined in terms of the wealth or assets of the households where they reside. The source of data is the Demographic and Health Survey (DHS) program, a large, multi-country household survey project. (excerpt)

This report is one in a series that provides basic information about health, nutrition, and population (hnp) inequalities within fifty-six developing countries. The series to which the report belongs is an expanded and updated version of a set covering forty-five countries that was published in 2000. The fifty-six reports in the current series cover almost all DHS surveys undertaken during the period beginning in 1990 and ending with the date of the last survey for which data were publicly available as of June 2006. The report's contents are intended to facilitate preparation of country analyses and the development of activities to benefit poor people. To this end, the report presents data about hnp status, service use, and related matters among individuals belonging to different socio-economic classes. The principal focus is on differences among groups of individuals defined in terms of the wealth or assets of the households where they reside. The source of data is the Demographic and Health Survey (DHS) program, a large, multi-country household survey project. (excerpt)

This report is one in a series that provides basic information about health, nutrition, and population (hnp) inequalities within fifty-six developing countries. The series to which the report belongs is an expanded and updated version of a set covering forty-five countries that was published in 2000. The fifty-six reports in the current series cover almost all DHS surveys undertaken during the period beginning in 1990 and ending with the date of the last survey for which data were publicly available as of June 2006. The report's contents are intended to facilitate preparation of country analyses and the development of activities to benefit poor people. To this end, the report presents data about hnp status, service use, and related matters among individuals belonging to different socio-economic classes. The principal focus is on differences among groups of individuals defined in terms of the wealth or assets of the households where they reside. The source of data is the Demographic and Health Survey (DHS) program, a large, multi-country household survey project. (excerpt)

This report is one in a series that provides basic information about health, nutrition, and population (hnp) inequalities within fifty-six developing countries. The series to which the report belongs is an expanded and updated version of a set covering forty-five countries that was published in 2000. The fifty-six reports in the current series cover almost all DHS surveys undertaken during the period beginning in 1990 and ending with the date of the last survey for which data were publicly available as of June 2006. The report's contents are intended to facilitate preparation of country analyses and the development of activities to benefit poor people. To this end, the report presents data about hnp status, service use, and related matters among individuals belonging to different socio-economic classes. The principal focus is on differences among groups of individuals defined in terms of the wealth or assets of the households where they reside. The source of data is the Demographic and Health Survey (DHS) program, a large, multi-country household survey project. (excerpt)

This report is one in a series that provides basic information about health, nutrition, and population (hnp) inequalities within fifty-six developing countries. The series to which the report belongs is an expanded and updated version of a set covering forty-five countries that was published in 2000. The fifty-six reports in the current series cover almost all DHS surveys undertaken during the period beginning in 1990 and ending with the date of the last survey for which data were publicly available as of June 2006. The report's contents are intended to facilitate preparation of country analyses and the development of activities to benefit poor people. To this end, the report presents data about hnp status, service use, and related matters among individuals belonging to different socio-economic classes. The principal focus is on differences among groups of individuals defined in terms of the wealth or assets of the households where they reside. The source of data is the Demographic and Health Survey (DHS) program, a large, multi-country household survey project. (excerpt)

This report is one in a series that provides basic information about health, nutrition, and population (hnp) inequalities within fifty-six developing countries. The series to which the report belongs is an expanded and updated version of a set covering forty-five countries that was published in 2000. The fifty-six reports in the current series cover almost all DHS surveys undertaken during the period beginning in 1990 and ending with the date of the last survey for which data were publicly available as of June 2006. The report's contents are intended to facilitate preparation of country analyses and the development of activities to benefit poor people. To this end, the report presents data about hnp status, service use, and related matters among individuals belonging to different socio-economic classes. The principal focus is on differences among groups of individuals defined in terms of the wealth or assets of the households where they reside. The source of data is the Demographic and Health Survey (DHS) program, a large, multi-country household survey project. (excerpt)

This report is one in a series that provides basic information about health, nutrition, and population (hnp) inequalities within fifty-six developing countries. The series to which the report belongs is an expanded and updated version of a set covering forty-five countries that was published in 2000. The fifty-six reports in the current series cover almost all DHS surveys undertaken during the period beginning in 1990 and ending with the date of the last survey for which data were publicly available as of June 2006. The report's contents are intended to facilitate preparation of country analyses and the development of activities to benefit poor people. To this end, the report presents data about hnp status, service use, and related matters among individuals belonging to different socio-economic classes. The principal focus is on differences among groups of individuals defined in terms of the wealth or assets of the households where they reside. The source of data is the Demographic and Health Survey (DHS) program, a large, multi-country household survey project. (excerpt)

This video CD contains 13 minute and 25 minute versions of a documentary that examines daily life in Nepal and the important role played by Female Community Health Volunteers through the eyes of one of those volunteers who lives in the Terai region. The documentaries show people going about their daily activities and also shows the volunteers interacting with their communities as they provide health information and services. Includes interviews with health volunteers and other Nepalese women. Shows excerpts from the street theater performance that was used to generate interest in the radio drama serial. The radio drama continued the story line presented in the street performances. The documentary also gives statistics about various health issues such as maternal and child mortality. The longer version of the documentary also shows the distribution of radios to the female community health volunteers, and some of their training activities.

For many years the social marketing of contraceptives was held to be an interesting but not a central part of the international family planning movement. The heavy lifting, everyone thought, would be performed by government programs, managed by developing country government agencies that would provide services and contraceptives free of charge. This attitude is changing. Although government programs are still the largest family planning service providers in many countries, the contraceptive needs of poor populations are increasingly being met by a wide variety of independently managed contraceptive social marketing (CSM) programs and by a growing number of commercial contraceptive suppliers. In 2005, social marketing programs served the contraceptive needs of 36.7 million couples in 73 countries and provided hundreds of millions of condoms for HIV/AIDS prevention. This contribution means that social marketing programs accounted for about six percentage points of the contraceptive prevalence in thedeveloping world (excluding China), and roughly 20 percent of the birth spacing methods used by couples in developing countries. (excerpt)