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Karen Hardee - One of the best experts on this subject based on the ideXlab platform.
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trends in Contraceptive Prevalence in sub saharan africa the roles of family planning programs and education
African Journal of Reproductive Health, 2019Co-Authors: John Bongaarts, Karen HardeeAbstract:Since the 1990s some countries in Africa have experienced very rapid increases in Contraceptive Prevalence (e.g. Ethiopia, Malawi, Rwanda), while others (e.g. Nigeria) have seen little change. This study aims to shed light on the causes of these different trends which remain controversial. We assess the role of family planning programs vs. socioeconomic development (especially, women‘s educational attainment). Estimates of the effects of different explanatory factors are obtained by country level regressions in which the Prevalence of modern contraception is the dependent variable and women‘s educational attainment, Gross National Income (GNI) per capita, percent urban and child mortality as well as the family planning program score are the independent variables. The statistical analysis finds no significant effects of GNI per capita, percent urban and child mortality. In contrast, women‘s educational attainment and program score have highly significant effects and are the dominant drivers of Contraceptive Prevalence trends. Voluntary family planning programs can increase Contraceptive Prevalence at all levels of female education. The best programs with Prevalence impact above 30% (relative to no program effort) are found in Zimbabwe, Malawi, Kenya, Rwanda, Zambia and Ethiopia. Without family planning programs Prevalence remains low even where education levels have risen substantially. (Afr J Reprod Health 2019; 23[3]:96-105).
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the role of public sector family planning programs in meeting the demand for contraception in sub saharan africa
International Perspectives on Sexual and Reproductive Health, 2017Co-Authors: John Bongaarts, Karen HardeeAbstract:CONTEXT Commonly used indicators of Contraceptive behavior in a population-modern Contraceptive Prevalence (mCPR), unmet need for contraception, demand for contraception and demand satisfied-are not well-suited for evaluating the progress made by government family planning programs in helping women and men achieve their reproductive goals. METHODS Trends in these measures in 26 Sub-Saharan African countries between 1990 and 2014 were examined. Trends in a proposed new indicator, the public-sector family planning program impact score (PFPI), and its relationship to mCPR and the family planning effort score were also assessed. Case studies were used to review public family planning program development and implementation in four countries (Nigeria, Ethiopia, Rwanda and Kenya). RESULTS The four commonly used indicators capture the extent to which women use family planning and to which demand is satisfied, but shed no direct light on the role of family planning programs. PFPI provides evidence that can be used to hold governments accountable for meeting the demand for family planning, and was closely related to policy developments in the four case-study countries. CONCLUSIONS PFPI provides a useful addition to the indicators currently used to assess progress in reproductive health and family planning programs.
John Bongaarts - One of the best experts on this subject based on the ideXlab platform.
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trends in Contraceptive Prevalence in sub saharan africa the roles of family planning programs and education
African Journal of Reproductive Health, 2019Co-Authors: John Bongaarts, Karen HardeeAbstract:Since the 1990s some countries in Africa have experienced very rapid increases in Contraceptive Prevalence (e.g. Ethiopia, Malawi, Rwanda), while others (e.g. Nigeria) have seen little change. This study aims to shed light on the causes of these different trends which remain controversial. We assess the role of family planning programs vs. socioeconomic development (especially, women‘s educational attainment). Estimates of the effects of different explanatory factors are obtained by country level regressions in which the Prevalence of modern contraception is the dependent variable and women‘s educational attainment, Gross National Income (GNI) per capita, percent urban and child mortality as well as the family planning program score are the independent variables. The statistical analysis finds no significant effects of GNI per capita, percent urban and child mortality. In contrast, women‘s educational attainment and program score have highly significant effects and are the dominant drivers of Contraceptive Prevalence trends. Voluntary family planning programs can increase Contraceptive Prevalence at all levels of female education. The best programs with Prevalence impact above 30% (relative to no program effort) are found in Zimbabwe, Malawi, Kenya, Rwanda, Zambia and Ethiopia. Without family planning programs Prevalence remains low even where education levels have risen substantially. (Afr J Reprod Health 2019; 23[3]:96-105).
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the role of public sector family planning programs in meeting the demand for contraception in sub saharan africa
International Perspectives on Sexual and Reproductive Health, 2017Co-Authors: John Bongaarts, Karen HardeeAbstract:CONTEXT Commonly used indicators of Contraceptive behavior in a population-modern Contraceptive Prevalence (mCPR), unmet need for contraception, demand for contraception and demand satisfied-are not well-suited for evaluating the progress made by government family planning programs in helping women and men achieve their reproductive goals. METHODS Trends in these measures in 26 Sub-Saharan African countries between 1990 and 2014 were examined. Trends in a proposed new indicator, the public-sector family planning program impact score (PFPI), and its relationship to mCPR and the family planning effort score were also assessed. Case studies were used to review public family planning program development and implementation in four countries (Nigeria, Ethiopia, Rwanda and Kenya). RESULTS The four commonly used indicators capture the extent to which women use family planning and to which demand is satisfied, but shed no direct light on the role of family planning programs. PFPI provides evidence that can be used to hold governments accountable for meeting the demand for family planning, and was closely related to policy developments in the four case-study countries. CONCLUSIONS PFPI provides a useful addition to the indicators currently used to assess progress in reproductive health and family planning programs.
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meeting demand for family planning within a generation the post 2015 agenda
The Lancet, 2015Co-Authors: Madeleine Short Fabic, John Stover, John Bongaarts, Yoonjoung Choi, John A Ross, Jacqueline E Darroch, Amy Ong Tsui, Jagdish Upadhyay, Ellen StarbirdAbstract:Expanding access to family planning has been a key aim of health and development programming for more than 40 years. During that time, significant gains have been made in reducing unmet need for family planning, increasing Contraceptive Prevalence, and preventing unintended pregnancies. Over the last two decades, however, the pace of these gains has slowed, especially in several countries in sub-Saharan Africa and South Asia. Not only does family planning enable individuals and couples to achieve their childbearing (family building?) goals, an ever growing body of research shows the wider beneficial impact of family planning on improving maternal and child health and survival, increasing economic well-being of individuals, families and communities, and empowering women.i,ii
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future trends in Contraceptive Prevalence and method mix in the developing world
Studies in Family Planning, 2002Co-Authors: John Bongaarts, Elof D B JohanssonAbstract:This study reviews existing methodologies for projecting future trends in contraception evaluates the validity of the assumptions underlying these projections proposes methodological improvements and assesses the prospects for new methods of contraception in the coming decade. Demand for contraception can be expected to continue to rise rapidly for the next few decades as populations continue to grow and fertility declines to approach replacement level. As a result of these trends the number of Contraceptive users in the developing world is expected to rise from 549 to 816 million during the next 25 years according to the most recent UN projection. An examination of the projection methodology found it to be reasonable. Projecting the future distribution of specific Contraceptive methods is more difficult. Method choice is affected by trends in several factors including access to different methods user characteristics and technology. The procedure employed by the Futures Group to project method mix was found to be less than optimally designed and a new methodology is therefore proposed. (authors)
Egon Diczfalusy - One of the best experts on this subject based on the ideXlab platform.
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Contraceptive Prevalence reproductive health and international morality
American Journal of Obstetrics and Gynecology, 1992Co-Authors: Egon DiczfalusyAbstract:This article is a transcript of the 58th Joseph Price Oration delivered by Egon Diczfalusy (MD PhD) at the 10th Annual Meeting of the American Gynecological and Obstetrical Society held in Carlsbad California on September 5-7 1991. In his speech Diczfalusy discussed the international communitys moral obligation to promoting reproductive health which hinges primarily on Contraceptive Prevalence. WHO figures indicate that 85% of the worlds births 95% of the worlds infant deaths and 99% of the worlds maternal deaths take place in developing countries. While a women in a developed country has a 1 in 1750 chance of dying from pregnancy-related causes the risk is 1 in 24 for a woman in Africa. The goals of reproductive health are well-known: reducing the unmet need for family planning increasing family planning services and methods; lessening maternal infant and child mortality and morbidity; and reducing the Prevalence of STDs. An investment of $2/capita would eliminate most maternal deaths in the developing world. An additional $2/capita spending increase in developing countries would also immunize all children eradicate polio and provide the drugs necessary to cure all cases of diarrheal disease acute respiratory infection tuberculosis malaria schistosomiasis and STDs. But the most important element with respect to reproductive health is increasing Contraceptive Prevalence. Over the next decade yearly world population increments will approach 97 million. 94% of this growth will take place in developing countries. As Diczfalusy explains the technology and resources to solve these problems exists. At bottom the obstacle to overcoming the problems is the lack of political will.
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Contraceptive Prevalence reproductive health and our common future
Contraception, 1991Co-Authors: Egon DiczfalusyAbstract:The 1980s will go into history as a decade of lost opportunities to increase Contraceptive Prevalence and improve reproductive health worldwide. As the decade closes, 500 million couples still have no access to fertility regulation, there are 30-50 million induced abortions each year, 15 million infant and child deaths (30% of all deaths worldwide), an estimated 250 million new cases of sexually transmitted diseases and 60-80 million infertile couples. One of the major problems is that many policy makers are still unimpressed with the global demographic reality. World population was less than 300 million 1991 years ago. It took some 1500 years to double this number by the time of the voyages of Columbus to America. The first billion was reached at the beginning of the last century and the second in the lifetime of the author, in 1927. Then it took less than 50 years to double this number to 4 billion by 1976. Global population is 5.3 billion today. In view of such figures, it is understandable that, historically, it was this demographic concern that in the 1960s persuaded many governments to support family planning programmes. During the subsequent decades, it was gradually recognized by developing country governments that family planning lowers infant, child and maternal mortality and morbidity and reduces the number of illegal abortions and their health hazards. Today, 52 developing country governments support family planning programmes for the demographic rationale, but 65 for the reproductive health and human rights rationale. Where do we go from here? That will mainly depend on the number of years it will take to reach replacement level of fertility (around 2.1 children per couple) worldwide. If the level is reached in 2010 (the low projection of the United Nations), global population will stabilize by the end of the 21st century at 8 billion; if it is reached in 2035 (medium projection), population will stabilize around 10 billion; however, if it is reached only in 2065 (high projection), the global population in 2100 will consist of more than 14 billion people, with major consequences on every walk of life. To restrict the final population to 10 billion, Contraceptive Prevalence must increase from 51% to 58% of married women of reproductive age before the year 2000 and to 71% by 2020, implying an increase from the present 350 million users to 500 and 800 million, respectively.(ABSTRACT TRUNCATED AT 400 WORDS)
John A Ross - One of the best experts on this subject based on the ideXlab platform.
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meeting demand for family planning within a generation the post 2015 agenda
The Lancet, 2015Co-Authors: Madeleine Short Fabic, John Stover, John Bongaarts, Yoonjoung Choi, John A Ross, Jacqueline E Darroch, Amy Ong Tsui, Jagdish Upadhyay, Ellen StarbirdAbstract:Expanding access to family planning has been a key aim of health and development programming for more than 40 years. During that time, significant gains have been made in reducing unmet need for family planning, increasing Contraceptive Prevalence, and preventing unintended pregnancies. Over the last two decades, however, the pace of these gains has slowed, especially in several countries in sub-Saharan Africa and South Asia. Not only does family planning enable individuals and couples to achieve their childbearing (family building?) goals, an ever growing body of research shows the wider beneficial impact of family planning on improving maternal and child health and survival, increasing economic well-being of individuals, families and communities, and empowering women.i,ii
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changes in the distribution of high risk births associated with changes in Contraceptive Prevalence
BMC Public Health, 2013Co-Authors: John Stover, John A RossAbstract:Several birth characteristics are associated with high mortality risk: very young or old mothers, short birth intervals and high birth order. One justification for family planning programs is the health benefits associated with better spacing and timing of births. This study examines the extent to which the Prevalence of these risk factors changes as a country transitions from high to low fertility. We use data from 194 national surveys to examine both cross section and within-country variation in these risk factors as they relate to the total fertility rate. Declines in the total fertility rate are associated with large declines in the proportion of high order births, those to mothers over the age of 34 and those with multiple risk factors; as well as to increasing proportions of first order births. There is little change in the proportion of births with short birth intervals except in sub-Saharan Africa. The use of family planning is strongly associated with fertility declines. The proportion of second and higher order births with demographic risk factors declines substantially as fertility declines. This creates a potential for reducing child mortality rates. Some of the reduction comes from modifying the birth interval distribution or by bringing maternal age at the time of birth into the ‘safe’ range of 18-35 years, and some comes from the actual elimination of births that would have a high mortality risk (high parity births).
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plateaus during the rise of Contraceptive Prevalence
International Family Planning Perspectives, 2004Co-Authors: John A Ross, Edward Abel, Katherine AbelAbstract:Although Contraceptive use has increased impressively in many countries over the past few decades, occasional flat periods have raised serious concerns about the effectiveness of the national action programs involved. Plateaus have occurred naturally at ceiling levels of use, as in China, Thailand, Vietnam, South Korea and Taiwan. They also have occurred at very low levels of use, before a clear upward trend has been established, as in several SubSaharan African countries. However, a third type of plateau— an occasional “stalling” or “hesitation” in well-established upward trends, when use has reached intermediate levels— has captured the most attention and caused governments and international supporting agencies to rethink program approaches. We report here on an analysis using data from a large set of national surveys to explore the frequency of such plateaus, why they occur and why they tend to be brief.
Neff Walker - One of the best experts on this subject based on the ideXlab platform.
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predicting high risk births with Contraceptive Prevalence and Contraceptive method mix in an ecologic analysis
BMC Public Health, 2017Co-Authors: Jamie Perin, Agbessi Amouzou, Neff WalkerAbstract:Background Increased Contraceptive use has been associated with a decrease in high parity births, births that occur close together in time, and births to very young or to older women. These types of births are also associated with high risk of under-five mortality. Previous studies have looked at the change in the level of contraception use and the average change in these types of high-risk births. We aim to predict the distribution of births in a specific country when there is a change in the level and method of modern contraception.