 Pregnancy Termination among South African Adolescents
Christine A. Varga is Chief Research Specialist, Program on Child, Youth, and Family Development, Human Sciences Research Council, Durban, South Africa. E-mail: cvarga@hsrc.ac.za. Although African adolescents’ risk of undergoing abortion and of related health complications is well-documented, little is known about the procedure’s prominence in their lives and the pathways that lead to their reliance upon it. This study investigates abortion dynamics among male and female Zulu adolescents in KwaZulu/Natal, South Africa. It explores the role of abortion in young people’s sexual and reproductive experience, its acceptability, the reasons and likelihood of young people’s choosing abortion, and the commonly used methods of pregnancy termination. The study, a rural–urban comparison using focus-group discussions, narrative workshops, and role playing, involved surveys and in-depth interviews. Factors contributing to the commonplace nature of backstreet procedures among adolescents include: social stigma, inadequate knowledge of the legal status of abortion, and a complex group decisionmaking process. Young people invoke “relative moralities” concerning adolescent abortion, recognizing and condoning it on a context-specific basis. Age, gender, and geographic differences are examined. The methodological triangulation used offers the opportunity for alternative theoretical and methodological approaches to research on abortion-related issues. (Studies in Family Planning 2002; 33[4]: 283–298)
Convergence and Divergence in Spouses’ Perspectives on Women’s Autonomy in Rural India (PDF)
Shireen J. Jejeebhoy is Senior Program Associate, Population Council, Zone 5A, Ground Floor, India Habitat Centre, Lodi Road, New Delhi 110003, India. E-mail: sjejeebhoy@popcouncil.org. This study explores similarities and differences in the perceptions of rural Indian women and their husbands with regard to various dimensions of women’s autonomy and investigates the extent to which various reproductive outcomes—contraception, unmet need, recent fertility, and spousal communication—are influenced by individual partners’ views of women’s autonomy. Data are drawn from a 1993–94 community-based study of women’s autonomy in Uttar Pradesh and Tamil Nadu, states that are, respectively, more and less patriarchal. Matched data were obtained from 1,660 women and their husbands. Results indicate no more than a loose agreement between women and their husbands concerning the dimensions of women’s autonomy within the home. Where disagreement is expressed, husbands are more likely to project a comparatively liberal picture of their wives’ autonomy than do their wives, and the inference can be made that in surveys men tended to provide more “acceptable” responses than when they were questioned in greater depth. Findings also suggest that cultural context affects the influences that wives’ and their husbands’ perceptions of women’s autonomy have on reproductive outcomes. A clear regional divide is seen, net of individual and household characteristics, in the influence of almost every aspect of women’s autonomy. (Studies in Family Planning 2002; 33[4]: 299–308)
Contextual Influences on Reproductive Health Service Use in Uttar Pradesh, India
Rob Stephenson is Research Associate and Amy Ong Tsui is Professor, Bill and Melinda Gates Institute for Population and Reproductive Health, Department of Population and Family Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, W4508, Baltimore, MD 21205–2179. E-mail: rstephenson@jhsph.edu. This study examines the determinants of the use of four types of reproductive health-care services in Uttar Pradesh, India: contraceptive services, antenatal care, delivery in a medical institution, and services dealing with reproductive tract and sexually transmitted infections. The analysis uses a multilevel modeling strategy to assess the presence of household- and community-level variation in service use. The influence of community-level characteristics and reproductive health-care service attributes on service use is examined. The results highlight strong community-level influences on service use, although the type of community effect varies by service type. The role of some individual and household factors in determining a person’s use of services is mediated by the characteristics of the community in which the individual lives. The results demonstrate the need to look beyond individual factors when examining health-care-seeking behavior, and illustrate that there is no singular “community” effect on service use. (Studies in Family Planning 2002; 33[4]: 309–320)
ReportsSon Preference in a Rural Village in North Vietnam
Danièle Bélanger is Associate Professor, Population Studies Center, The University of Western Ontario, London, ON, Canada, N6A 5C2. E-mail: dbelang@uwo.ca This article explores the continuing preference for sons in the context of low fertility in Vietnam. Although the total fertility rate for Vietnam declined from 6.0 children per woman of reproductive age in 1979 to 2.2 children in 1998, demographic evidence shows that son preference remains strong and influences contraceptive and fertility behavior. This study examines the underlying factors for son preference in a rural village in North Vietnam. The methodology includes focus-group discussions, an in-depth study of 25 families, and ethnographic observation. Results indicate that sons are highly desired for their social, symbolic, and economic value. In spite of four decades of socialist policies aimed at reducing gender-based inequalities and at weakening the patriarchal kinship system, the desire for sons continues to drive the family-building process. The article also indicates a gap between discourse and social practice with respect to roles assigned to children on the basis of their sex. (Studies in Family Planning 2002; 33[4]: 321–334)
Determinants of Condom Use among Young People in Urban Cameroon
Dominique Meekers is Professor, Department of International Health and Development, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 2200, New Orleans, LA 70112. E-mail: dmeekers@tulane.edu. Megan Klein is a graduate researcher, Department of Sociology, University of Maryland, College Park, MD. To reduce the prevalence of reproductive health problems among adolescents, governmental and nongovernmental organizations in Cameroon are implementing youth-oriented reproductive health programs. To facilitate the design of effective programs to increase condom use, this study examines survey data on the determinants of having ever used condoms and on current condom use with regular and casual partners among unmarried young people in urban Cameroon. While most adolescents have tried condoms at least once, use remains inconsistent. Parental support, personal risk perception, and self-efficacy are found to be associated with higher levels of condom use. Youth-oriented programs seeking to increase the number of new condom users among the young should promote parental support for condom use and enhance young people’s perceptions of personal risk. Programs that work to convince the young that their sexual history can put them at risk of HIV infection and that dispel the myth that HIV risk with regular partners is low may serve to increase personal risk perception. Finally, communications programs should aim to increase adolescents’ self-efficacy, particularly in terms of their perceived ability to convince partners to use condoms and to use them correctly. (Studies in Family Planning 2002; 33[4]: 335–346)
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