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MEDIA CENTER Quality—Not Quantity—of Family Planning Services NEW YORK (12 July 2002) — As more and more couples practice contraception, the quality—as opposed to quantity—of family planning services will become increasingly important, says a new study in the latest issue of Studies in Family Planning. The June issue of the peer-reviewed quarterly journal, published by the Population Council, includes an analysis of Demographic and Health Survey data from 15 developing countries. Demographer Ann Blanc and her colleagues used the data to examine the rate at which women discontinue using contraceptive methods and their reasons for doing so. "As desired family size declines and contraceptive prevalence rises, the ability of couples to achieve their reproductive intentions will depend increasingly on the effectiveness and continuity with which they practice contraception," the authors say. "Contraceptive continuation, in turn, is thought to be linked strongly with the quality of the family planning service environment." The authors suggest that as fertility declines, family planning programs can achieve better demographic results when they concentrate on providing clients with good care to enhance their satisfaction and thereby improve continuation rates, rather than on trying to recruit a large number of clients at one time without providing them with high-quality care. Aside from their effect on fertility rates, pregnancies that result from contraceptive failure and discontinuation can also influence induced abortion rates and may have negative health effects on women. The authors group the many reasons that women stop using contraceptives into three categories. Quality-related reasons include contraceptive failure, desire for a more effective method, side effects, health concerns, lack of access, cost, and inconvenience of using the method. Reasons related to a reduced need for contraception include wanting to become pregnant, having infrequent sex or the absence of a partner, being menopausal or subfecund, and marital dissolution or separation. Other reasons include a partner's disapproval, being fatalistic, and other unspecified reasons. Blanc and colleagues found that contraceptive discontinuation for quality-related reasons is a relatively common event in all countries. Within a year of beginning to use a method, between 7 and 27 percent of women in the surveyed countries stop practicing contraception for reasons related to the quality of the service environment. Between 40 and 60 percent of the overall discontinuation rate reflects decisions based on these reasons. "The results imply that as fertility declines, family planning programs would profit from a shift from providing methods to new clients toward providing services, such as counseling, that may help reduce discontinuation rates," the authors conclude. Ann Blanc is Demographer, Blancroft Research International. Siân L. Curtis is Senior Evaluation Analyst, and Trevor N. Croft is Chief of Data Processing, Macro International. For subscription information on Studies in Family Planning, call 212-339-0514, fax 212-755-6052, or email publications@popcouncil.org.
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