Articles
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What Drives Donor Funding in Population Assistance Programs? Evidence
from OECD Countries
Hendrik P. van Dalen is Research Fellow, Tinbergen Institute,
Erasmus University, Rotterdam, and Senior Research Associate,
Netherlands Interdisciplinary Demographic Institute (NIDI), Post Office
Box 11650, NL-2502 AR The Hague, The Netherlands. E-mail:
dalen@nidi.nl. Mieke Reuser is
NIDI fellow, European Doctoral School of Demography, Max Planck
Institute for Demographic Research.
The 1994 International Conference on Population and Development (ICPD)
established goals for the expansion of population assistance. To date,
the financial promises made by donor countries in 1994 have not been
met. To unravel the gap between ambitions and contributions, we use
panel estimation methods to see what lies behind the level of donor
contributions and the sharing of burdens across the various categories
of population and HIV/AIDS assistance in 21 donor countries for the
years 1996–2002. Contributions by donors depend heavily on the economic
wealth and subjective preferences of donor countries. The sharing of the
ICPD burden within the group of OECD/DAC countries is in line with the
countries' ability to pay, although within the aggregate we observe a
specialization in channels for aid: small countries predominantly use
multilateral aid agencies, whereas large countries rely more on
bilateral aid channels. Catholic countries are averse to donating
unrestricted funds (flowing primarily to multilateral agencies) or
restricted funds targeted at family planning programs. (Studies in
Family Planning 2006; 37[3]: 141–154)
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Challenges to Integrating Sexual Health Issues into Reproductive
Health Programs in Uzbekistan
Cynthia Buckley
is Associate Professor, Department of Sociology, Center for Innovation,
Creativity and Capital, The University of Texas, Austin. E-mail:
cbuckley@mail.la.utexas.edu.
This study examines the direction and result of efforts of
nongovernmental organizations (NGOs) in the area of reproductive and
sexual health in Uzbekistan. It focuses specifically on the
institutional, structural, epidemiological, and cultural forces
responsible for the exclusion of sexual health issues from reproductive
health campaigns in the most populous Central Asian country. In
Uzbekistan, as in other countries of the region, significant
international support was given to NGOs providing reproductive health
services in the mid-to-late-1990s, well into the early period of the
HIV/AIDS pandemic and after the 1994 mandate of the International
Conference on Population and Development for the inclusion of sexual
health as a key reproductive health component. Examining the exclusion
of sexual health issues from reproductive health campaigns in Uzbekistan
highlights problems relating to time lags in program and evaluative
development and the difficulties NGOs experienced in balancing
donor-state agendas with recipient-state priorities. Findings question
standard assumptions regarding the advantageous structural aspects of
NGOs, in terms of flexibility, responsive agenda generation, and state
independence. (Studies in Family Planning 2006; 37[3]: 155–168)
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Advanced Methods for Evaluating the Impact of Family Planning
Communication Programs: Evidence from Tanzania and Nepal
Paul Hutchinson
is Research Assistant Professor and Jennifer Wheeler is a
doctoral candidate, 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:
phutchin@tulane.edu.
Evaluations of national family planning communication campaigns are
often complicated by nonrandomized research designs and self-reported
measures of exposure to media messages, both of which can bias estimates
of campaign effectiveness if suitable analytical methods are not
employed. This study uses three methods to address these problems: (1)
single-equation multiple regression analysis; (2) propensity score
matching (PSM); and (3) maximum-likelihood simultaneous equation models
(SEM), namely bivariate probit. We use these methods to evaluate the
impact of family planning health-communication campaigns on the use of
modern family planning methods, focusing primarily on the radio drama
Zinduka!
in Tanzania and Ghanti Heri Haad Nilaun in Nepal. We find that
these methods led to substantially different estimates of the magnitude
of the impact of these communication campaigns. Specifically, we found
that self-reported exposure to each radio program was exogenously
related to family planning use and that PSM and multiple regression
analysis gave similar estimates in those situations. An indicator of
exposure to any type of family planning message was found to be
endogenous, in which case bivariate probit and PSM gave different
estimates of program impact. Researchers should, therefore, pay close
attention to the results of tests for endogeneity and identification
that guide the appropriate use of the different methods. (Studies in
Family Planning 2006; 37[3]: 169–186)
Reports
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Emergency Contraception in Honduras: Knowledge, Attitudes, and Practice
Among Urban Family Planning Clients
Sandra G. García
is Director, Diana Lara is Regional Staff Assistant, and
Eileen A. Yam is Regional Program Associate, Reproductive Health,
Population Council, Latin America and the Caribbean Regional Office,
Escondida 110, Col. Villa Coyoacán, Mexico
City, Mexico. E-mail:
sgarcia@popcouncil.org.mx.
Sarah H. Landis is a doctoral candidate, Department of
Epidemiology, School of Public Health, The University of North Carolina
at Chapel Hill. Suyapa Pavón is
Director of Research, Evaluation, and Statistics, Asociación
Hondureña de Planificación
de la Familia, Tegucigalpa, Honduras.
Emergency contraception (EC) has the potential to improve women's
reproductive health significantly. In Honduras, where nearly one-fourth
of pregnancies are unplanned, the need for EC is substantial. To
increase awareness of this option, nongovernmental organizations
launched countrywide EC outreach activities in 2001–03. We conducted
pre- and postintervention cross-sectional surveys among a total of 2,693
family planning clinic clients to assess EC knowledge, attitudes, and
practice at baseline and at two years postintroduction. EC awareness
increased over time, but remained at just 20 percent at follow-up.
Respondents generally demonstrated a positive attitude and low rates of
concern about EC. Awareness of and willingness to use EC were strongly
associated with age, educational status, and city of residence.
Public-sector acceptance of the method is essential to increase
awareness of and access to EC. This study is intended to fill an
information gap regarding EC in Latin America and the Caribbean and to
be useful in determining educational messages and target audiences for
future awareness campaigns in Honduras. (Studies in Family Planning
2006; 37[3]: 187–196)
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Over-the-Counter Access, Changing WHO Guidelines, and Contraindicated
Oral Contraceptive Use in Mexico
Sara E. Yeatman
is a doctoral candidate, and Joseph E. Potter is Professor of
Sociology and Faculty Research Associate, Department of Sociology,
Population Research Center, The University of Texas at Austin, 1800 Main
Building, Austin, TX 78712. E-mail:
yeatman@prc.utexas.edu.
Daniel A. Grossman is Medical Associate, Ibis Reproductive Health,
University of California, San Francisco.
This study examines the prevalence of contraindications to the use of
oral contraceptives in Mexico by sociodemographic characteristics and by
whether this family planning method was obtained with or without a
doctor's prescription. Using data on smoking behavior and blood-pressure
measurements from the 2000 Mexican National Health Survey, the authors
found that, under the 1996 World Health Organization (WHO) medical
eligibility guidelines, the prevalence of contraindications is low and
that no significant differences in contraindications exist at any level
between those who obtain oral contraceptives at clinics and those who
obtain them at pharmacies. In 2000, however, WHO substantially revised
its criteria regarding the level of hypertension that would constitute a
contraindication for oral contraceptive use. Applying the new
guidelines, the authors found that 10 percent of pill users younger than
35 and 33 percent aged 35 and older have health conditions that are
either relative or absolute (Category 3 or 4) contraindications. The
relevance of these findings to the larger debate concerning screening
and over-the-counter access to oral contraceptives is discussed.
(Studies in Family Planning 2006; 37[3]: 197–204)
Data
Book Reviews
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Ravi K. Verma, Pertti J. Pelto, Stephen L. Schensul, and Archana Joshi,
editors
Sexuality in the Time of AIDS: Contemporary Perspectives from
Communities in India
Carla Makhlouf Obermeyer
is Scientist, Department of HIV, World Health Organization.
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Wendy Chavkin and Ellen
Chesler, editors
Where Human Rights Begin: Health, Sexuality, and Women in the New
Millennium
Charles Ngwena
is Professor, Department of Constitutional Law and Philosophy of Law,
University of the Free State, South Africa.
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Jennifer Johnson-Hanks
Uncertain Honor: Modern Motherhood in an African Crisis
Daniel Jordan Smith
is Stanley J. Bernstein Assistant Professor in the Social Sciences and
Assistant Professor of Anthropology, Department of Anthropology, Brown
University.
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