 The Quality of Family Planning Programs: Concepts, Measurements, Interventions, and Effects (PDF)
Saumya RamaRao is Program Associate, International Programs Division, Population Council. E-mail: sramarao@popcouncil.org. Raji Mohanam is Account Manager, Embryon, Inc., Somerville, New Jersey. This study reviews the major research and interventions concerning readiness and quality of care in family planning programs. It has three aims: to identify and describe the principal methodological research including conceptual frameworks, perspectives, and tools for measuring and improving quality; to describe the results from various intervention studies; and to assess what is known about the effect of such interventions. The review suggests that interventions that improve client–provider interactions show the greatest promise. Good quality of care results in such positive outcomes as clients’ satisfaction, increased knowledge, and more effective and longer use of contraceptives. Rigorously documented evidence of the effects of interventions is sorely needed. The review indicates areas requiring additional research. (Studies in Family Planning 2003; 34[4]: 227–248)
Adolescents in Vietnam: Looking Beyond Reproductive Health (PDF)
Barbara S. Mensch is Senior Associate, Policy Research Division, Population Council, New York. E-mail: bmensch@popcouncil.org. Wesley H. Clark is a consultant in international health. Dang Nguyen Anh is Director of the Population and Development Program, Vietnam Asian-Pacific Economic Center, and was Senior Researcher at the Institute of Sociology in Hanoi at the time the survey was conducted. The research that has been conducted to date on Vietnamese adolescents has focused on unprotected and unsanctioned sexual activity and its health consequences, specifically abortion and sexually transmitted diseases, especially HIV. The question we pose in this article is whether this concern is warranted. Is the population community justified in limiting research on this population to early sexual activity and HIV risk? Even if the sexual behavior of young people can be considered problematic, are there perhaps other aspects of young peoples’ lives to which more attention should be devoted? The literature on adolescent sexual behavior in Vietnam is reviewed and data on premarital sex and reproductive behavior are analyzed from a 1999 survey conducted in six provinces among nearly 1,500 adolescent boys and girls aged 15–22. Descriptive data on schooling and work are included in order to put the information on sexual activity in perspective. The data analysis reveals that, at least currently, the sexual behavior of unmarried adolescents in Vietnam is not what jeopardizes their health and well-being. (Studies in Family Planning 2003; 34[4]: 249–262)
ReportsDeterminants of Contraceptive Method Choice in Rural Tanzania Between 1991 and 1999
Susan Chen is a doctoral degree candidate, Department of Economics, and David K. Guilkey is Professor of Economics, The Carolina Population Center, University of North Carolina, Gardner Hall, CB#3305, Chapel Hill, NC 27599–3305. E-mail: david_guilkey@unc.edu. Four pooled Demographic and Health Survey data sets are used to examine the determinants of contraceptive method choice in rural Tanzania for the period from 1991 to 1999. The individual data are linked to facility surveys conducted in the same communities so that the impact of Tanzania’s family planning program can be examined. The focus of the study is an examination of the effect on method choice of the three major components of Tanzania’s family planning program: logistical support, trained providers, and communications programs. The statistical methods employed correct for the potential endogeneity of family planning message recall. Simulations are used to quantify the impact of the important policy variables. All three components of the program are shown to have had an impact on modern method choice. (Studies in Family Planning 34[4]: 263–276)
Abortion Service Provision in South Africa Three Years After Liberalization of the Law
Kim Eva Dickson is Clinical Director, Heather Brown is Senior Research Clinician, Helen Rees is Executive Director, and Luyanda Mavuya is Project Coordinator, Reproductive Health Research Unit, University of the Witwatersrand and Chris Hani-Baragwanath Hospital, PO Bertsham, 2013, South Africa. E-mail: kimdt@rhrujhb.co.za. Rachel K. Jewkes is Director, Gender and Health Group, Medical Research Council, Pretoria. Jonathan Levin is Chief Statistician, Bio-statistics Unit, Medical Research Council, Pretoria. In 1996, South Africa introduced legislation that liberalized women’s access to termination of pregnancy. This study presents the findings of a survey undertaken to describe the availability and accessibility of abortion services in 1999, three years after the law was passed. All facilities that had been officially designated to perform these services were contacted by telephone to determine whether they were providing the services, their capacity, whether they were performing second-trimester as well as first-trimester terminations, and how long women had to wait for these services. Nationally, 292 facilities had been designated, but in 1999 only 32 percent were functioning. Of the functioning facilities, 27 percent were in the private sector. Mapping of available services indicated that substantial parts of the country were entirely without such services. Half of the country’s induced abortions were being performed in Gauteng province, although only 19 percent of women of reproductive age were living there. This finding indicates that service provision in other provinces was inadequate or lacking. Although in the first years following the new legislation efforts were made to establish abortion services, this study reveals gross inequality in service availability. Strategies for improving coverage are suggested. (Studies in Family Planning 2003; 34[4]: 277–284)
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