 Gigi Santow and Michael Bracher, Senior Research Associates, Demography Unit, Stockholm University, Stockholm S-106 91, Sweden. The teenage fertility rate fell precipitately in Sweden after 1966 and is now one of the lowest in Europe. This decline can be seen in the context of major reforms enacted in 1975 whereby the school sex-education curriculum was revised, contraceptive services were improved, and abortion was provided free and on demand. By means of microsimulation, the possible roles of contraception and induced abortion in causing teenage fertility to fall are examined. Before 1975, the decline appears to have been caused primarily by an increase in the number of induced abortions. After that date, however, an increase in the use of highly efficient methods of contraception led to a decline in the pregnancy rate in such a way that, even though the proportion of teenagers who sought abortion increased, the abortion rate declined. Parallels are drawn with the experience of other European countries, and contrasts with that of the United States, where no such developments have occurred, are noted. (Studies in Family Planning 1999; 30[3]: 169–182)
Mary Arends-Kuenning, Assistant Professor, Department of Agriculture and Consumer Economics, University of Illinois, Urbana-Champaign, 408 Mumford Hall, MC710, 1301 West Gregory Drive, Urbana, IL 618013681. Mian Bazle Hossain, Statistician/Demographer, Operations Research Project, and Barkat-e-Khuda, Chief of Party, Operations Research Project and Division Director, Health and Population Extension Division, International Centre for Diarrhoeal Disease Research (ICDDR,B), Dhaka, Bangladesh. Should family planning programs put more effort into persuading couples to want smaller families or into helping women achieve their reproductive goals? Indeed, can family planning programs affect fertility preferences? Longitudinal data from Bangladesh collected from 1982 to 1993 show that women's desired family sizes have declined dramatically. This study examines how the decline in desired family size is related to visits from family planning workers for three intervals: 1982–85, 1985–90, and 1990–93. By use of logistic-regression analysis, the number of rounds during which women received visits from family planning workers is found to have no statistically significant effect on the probability that women altered their preference from wanting more children at the beginning of an interval to wanting no more at the end of the interval. (Studies in Family Planning 1999; 30[3]: 183–192)
Everett M. Rogers, Regents' Professor, Department of Communication and Journalism, University of New Mexico, Albuquerque, NM 871311171. E-mail: ERogers@UNM.edu. At the time this study was conducted, Peter W. Vaughan was Research Consultant, Ramadhan M.A. Swalehe was Research Assistant, Nagesh Rao was Assistant Professor, Peer Svenkerud was Assistant Professor, and Suruchi Sood was Teaching Assistant, University of New Mexico, Albuquerque. An entertainment-education radio soap opera introduced in Tanzania in 1993 was evaluated by means of a field experimental design in which the radio program was broadcast by seven mainland stations of Radio Tanzania. An eighth station broadcast alternative programming from 1993 to 1995, its listenership serving as a comparison area in which contemporaneous changes in family planning adoption were measured. The soap opera was subsequently broadcast nationwide from 1995 to 1997. Data about the effects of the radio soap opera were gathered in five annual surveys of about 2,750 households in the comparison and the treatment areas and from a sample of new family planning adopters in 79 health clinics. The soap opera had strong behavioral effects on family planning adoption; it increased listeners' self-efficacy regarding family planning adoption and influenced listeners to talk with their spouses and peers about contraception. (Studies in Family Planning 1999; 30[3]: 193–211)
ReportsDaniel Goodkind, Demographer, U.S. Bureau of the Census, International Programs Center, Room 117, Washington Plaza II, Washington, DC 202338860. E-mail: Daniel.M.Goodkind@ccmail.census.gov Son preference in South Korea is stronger than anywhere else in the world, yet little is known about such preference in North Korea. Simple indicators of son preference in North Korea are constructed from its 1993 population census and a 1998 survey of child nutrition (conducted in the wake of the recent famine). These indicators include sex ratio at birth, sex ratios of infant and child mortality, and sex ratios of child malnutrition. North Koreans do not evince prenatal discrimination against daughters, a finding that may indicate a lack of prenatal sex-testing technologies. Neither is evidence found of excess female mortality or malnutrition in the postnatal period, during which discrimination requires no special technology. The discrepancy in son preference across the Korean peninsula seems due largely to the socialist agenda pursued in the north following political partition after World War II. An important aspect of that agenda challenged the ancient Confucian ideology presumed to underlie son preference. Apparently, this challenge was more successful in North Korea than in other Asian societies instituting similar political changes, because son preference was not eliminated in China or in Vietnam. (Studies in Family Planning 1999; 30[3]: 212–218)
Heidi Jones, Data Analyst, Impact Studies Program. Nafissatou Diop, Program Associate, and Ian Askew, Associate Director for Africa, Frontiers in Reproductive Health Project, Population Council. Inoussa Kaboré, Host Country Social Scientist, Burkina Faso office, Population Council. Observations of the types of female genital cutting and possible associated gynecological and delivery complications were undertaken in 21 clinics in rural Burkina Faso and in four rural and four urban clinics in Mali. Women who came to the clinics for services that included a pelvic exam were included in the study, and trained clinic staff observed the presence and type of cut and any associated complications. Ninety-three percent of the women in the Burkina Faso clinics and 94 percent of the women in the Mali clinics had undergone genital cutting. In Burkina Faso, type 1 (clitoridectomy) was the most prevalent (56 percent), whereas in Mali the more severe type 2 cut (excision) was the most prevalent (74 percent); 5 percent of both samples had undergone type 3 cutting (infibulation). Logistic regression analyses show significant positive relationships between the severity of genital cutting and the probability that a woman would have gynecological and obstetric complications. (Studies in Family Planning 1999; 30[3]: 219–230)
Sarah Castle, Lecturer, Centre for Population Studies, London School of Hygiene and Tropical Medicine, 4951 Bedford Square, London WC1B 3DP, England. Mamadou Kani Konaté, Program Officer, Women, Families, and Development Program, Centre d'Etudes et de Recherche sur la Population pour le Développement, Bamako, Mali. At the time this article was written, Priscilla R. Ulin was Head, Women's Studies Project, and Sarah Martin was Research Analyst, Family Health International, Research Triangle Park, NC. This prospective study uses qualitative methods to examine the social and economic impact of family planning on women's lives in the district of Bamako, Mali. Fifty-five first-time users of contraceptives were interviewed in October 1996. Of particular interest is the high proportion (17/55) of those who had hidden their use of a birth-control method from their husbands. Substantial collusion is found to have occurred between sisters-in-law in assisting each other to gain and hide methods of family planning and to keep their use secret from their spouses and older marital relatives. The main reason for discontinuation among the clandestine users was menstrual disruption, which they feared would make their husbands aware of their contraceptive use. By the end of the study, women were aware that their use of contraceptives had increased their mobility and available time, enabling them to enhance the quantity and efficiency of their work activities. Contraception, therefore, appears to be a valuable resource, permitting women to improve their economic and social status. In settings where clandestine use is prevalent, at least in the short term involving men in family planning programs may not always be beneficial, nor may considering the couple as the unit of intervention and analysis always be appropriate. In the long term, however, the underlying causes of men's objections to contraceptive use need to be addressed so as to facilitate communication and joint decisionmaking about family planning (Studies in Family Planning 1999; 30[3]: 231–248)
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