 Mary Ellsberg is Research Associate and Anna Winkvist is Associate Professor, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. E-mail: mary.ellsberg@epiph.umu.se. Lori Heise is Senior Program Officer, Program for Appropriate Technology in Health (PATH), Washington, DC. Rodolfo Peña is Lecturer in Epidemiology, Department of Preventive Medicine, University of León, León, Nicaragua. Sonia Agurto is Research Associate, International Foundation for Global Challenges, Managua, Nicaragua. Correspondence should be directed to Dr. Ellsberg at 8909 Sudbury Road, Silver Spring, MD 20901. The results of three population-based studies on violence against women in Nicaragua are compared in this article. Two of the studies were regional in scope (León and Managua) and focused specifically on women's experiences of violence, whereas the third study was a Demographic and Health Survey (DHS) conducted with a nationally representative sample of women. The lifetime prevalence estimates for women's undergoing physical violence from a partner were significantly higher in the León study (52 percent) and Managua study (69 percent), compared with that given in the DHS (28 percent). Possible explanations for the differences are examined through pooled multivariate logistic regression analysis, as well as analysis of six focus-group discussions carried out with field-workers and staff from the three studies. The most important differences that were found concerned ethical and safety procedures and the interview setting. The results indicate that prevalence estimates for violence are highly sensitive to methodological factors, and that underreporting is a significant threat to validity. (Studies in Family Planning 2001; 32[1]: 116)
Eltigani E. Eltigani, Assistant Research Professor, Social Research Center, American University in Cairo, 113 Kasr El Aini Street, Cairo, Egypt. E-mail: Tigani@aucegypt.edu. The life-table technique is used in this study to describe childbearing patterns in five Arab countries (Algeria, Egypt, Morocco, Sudan, and Yemen). Two summary measures are estimated: the cumulative proportion of women of a given parity having a subsequent birth within 60 months of the previous birth (quintum), and the median length of the interval between successive births. The analysis indicates that in Yemen (where the total fertility rate exceeds seven children per woman of reproductive age), women begin childbearing at a relatively early age and a large proportion of ever-married women reach high parity at a relatively fast pace. Morocco and Egypt (with TFRs of 3.3 and 3.8 children per woman, respectively) are characterized by delay in the onset of childbearing, a slow pace of childbearing, and a smaller proportion of ever-married women reaching high parity. In Algeria and Sudan (with TFRs of 4.4 and 4.6 children), delay in the onset of childbearing plays a larger role in fertility reduction than do the tempo or the quantum of childbearing. (Studies in Family Planning 2001; 32[1]: 1724)
Virgile Capo-chichi is Researcher at the Centre de Recherche en Reproduction Humaine et en Démographie, Cotonou, Benin. Fatima Juarez is Senior Lecturer at the Center for Population Studies, Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, 4951 Bedford Square, London WC1B 3DP, United Kingdom. E-mail: f.juarez@lshtm.ac.uk. This study analyzes reproductive changes in Benin, a West African country with high fertility and low prevalence of use of modern contraceptive methods, using a combination of quantitative and qualitative approaches. Findings indicate that an irreversible fertility transition has started as the result of an emerging pattern of birth limitation and continued desire for the traditional long birth intervals. The data suggest that changes in childhood mortality in combination with an increase in women's education, although modest, have created a demand for fertility control among women; that induced abortion may be one of the means through which such demand is being met, particularly in urban areas; and that the economic crisis of the 1980s was the main catalyst that precipitated the onset of transition. Changes in reproductive preferences and practice suggest a diffusion process, from urban and more educated women to rural and less-educated ones. (Studies in Family Planning 2001; 32[1]: 2540)
ReportsPinar Senlet is Senior Program Advisor, USAID/Turkey, United States Embassy, Ankara, Turkey, E-mail: psenlet@usaid.gov. Siân L. Curtis is Senior Evaluation Analyst, MEASURE Evaluation Project, ORC Macro, Calverton, MD. At the time this study was conducted, Jill Mathis was Assistant Population Advisor, USAID/Turkey and currently is Gates Foundation Liaison, Population, Health and Nutrition Center, USAID/Washington, DC. Han Raggers is Data Processing Specialist, International Surveys and Data Processing, Balkbrug, The Netherlands. The induced abortion rate in Turkey declined from a peak of 4.5 abortions per 100 women in 1988 to 2.4 in 1998. This study examines the extent to which the decline in abortion in Turkey can be attributed to increased use of modern contraceptives. Trends in induced abortion rates and in contraceptive use are examined among Turkish women together with fertility preferences, changes in the contraceptive behavior associated with abortion, and changes in the propensity to abort unwanted pregnancies. The analysis includes a number of simulations that examine what abortion levels might be in different contraceptive-use scenarios. Results indicate that the decline in abortion is due to a decrease in the number of abortions associated with traditional method failure. This decrease is related to three factors: a shift from traditional method use to modern method use, a decline in the traditional method failure rate, and a decline in the proportion of pregnancies resulting from traditional method failures that are aborted. (Studies in Family Planning 2001; 32[1]: 4152)
Robert J. Magnani is Professor, Eric E. Seiber is Research Assistant Professor, and Emily Zielinski Gutierrez is a doctoral candidate, Tulane University, School of Public Health & Tropical Medicine, New Orleans, LA. Dorina Vereau is Assessor for Adolescents of Projecto Alcance, Pathfinder International, Lima, Peru. Correspondence should be addressed to Robert J. Magnani, Tulane University Health Sciences Center, School of Public Health & Tropical Medicine, Department of International Health & Development, 1440 Canal Street, Suite 2200, New Orleans, LA 70112. E-mail: magnani@mailhost.tcs.tulane.edu. Recent data indicate that adolescent fertility rates in Peru remain high and that Peruvian adolescents and young adults account for a disproportionate share of new HIV infections. The present study was undertaken to identify key risk and protective factors for early sexual activity and unprotected sex among secondary-school students in nine large cities in Peru. Survey data from 6,962 students aged 1318 are consistent with existing research in indicating that behaviors of Peruvian youth are influenced in important ways by many factors. In the present study, these included region of residence, family economic position, family structure, working for pay, peer behaviors, and self-esteem. Knowledge of pregnancy and of the risks of acquiring sexually transmitted diseases and of the means of avoiding both did not, however, differentiate risk-takers from non-risk-takers. The study findings suggest a need for adolescent health programs to broaden their focus beyond the immediate proximate determinants of behavior, such as sexual and reproductive health knowledge and access to contraceptives, and also to target some of the key contextual factors influencing adolescent behavior. (Studies in Family Planning 2001; 32[1]: 5366)
Rosemary Santana Cooney, Professor and Chair, Department of Sociology and Anthropology, Fordham University, Rose Hill Campus, Dealy Hall, Room 407, Bronx, NY 104589993. E-mail: rcooney@fordham.edu. Jiali Li, Research Scientist, New York City Department of Health. Using fertility survey data from the 1980s for registered Han peasant couples in Hebei Province, this study examines whether China's family planning policy reflects couples' voluntary compliance with policy regulations, their coercion by means of government sanctions, or a combination of both. Three family planning regulations are considered: birth-quota status, contraceptive use, and length of prior birth interval. The results of the study provide support for both compliance and sanction perspectives and suggest that by the late 1980s, the state was less willing than it had been previously to negotiate with couples who had had three children. Evidence is found of cooperation between couples and the state to ensure that each family had at least one son. (Studies in Family Planning 2001; 32[1]: 6778)
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