Studies in Family Planning最新文献

{"title":"Interrupted Access to and Use of Family Planning Among Youth in a Community-Based Service in Zimbabwe During the First Year of the COVID-19 Pandemic.","authors":"Constancia V Mavodza, Sarah Bernays, Constance R S Mackworth-Young, Rangarirayi Nyamwanza, Portia Nzombe, Ethel Dauya, Chido Dziva Chikwari, Mandikudza Tembo, Tsitsi Apollo, Owen Mugurungi, Bernard Madzima, Katharina Kranzer, Rashida Abbas Ferrand, Joanna Busza","doi":"10.1111/sifp.12203","DOIUrl":"10.1111/sifp.12203","url":null,"abstract":"<p><p>The COVID-19 pandemic has had serious impacts on economic, social, and health systems, and fragile public health systems have become overburdened in many countries, exacerbating existing service delivery challenges. This study describes the impact of the COVID-19 pandemic on family planning services within a community-based integrated HIV and sexual and reproductive health intervention for youth aged 16-24 years being trialled in Zimbabwe (CHIEDZA). It examines the experiences of health providers and clients in relation to how the first year of the pandemic affected access to and use of contraceptives.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"53 3","pages":"393-415"},"PeriodicalIF":1.9,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9350188/pdf/SIFP-9999-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9952736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abortion Legalization in Uruguay: Effects on Adolescent Fertility.","authors":"Wanda Cabella,&nbsp;Cecilia Velázquez","doi":"10.1111/sifp.12204","DOIUrl":"https://doi.org/10.1111/sifp.12204","url":null,"abstract":"<p><p>The Latin American and Caribbean adolescent fertility rates are among the highest in the world: about 1.7 million children are born to teen mothers every year, and most of them are declared unintended pregnancies. The region also has the highest rate of unintended pregnancy of any world region, and nearly half of such pregnancies end in abortion. However, fewer than 18 percent of the region's women live in countries where abortion is broadly legal. This paper estimates the causal effect of abortion legalization on adolescent fertility in Uruguay using official data on legal abortions provided after the 2012 reform. We employed a difference-in-differences strategy, classifying states by whether they are responsive or unresponsive to the reform. The results suggest that abortion reform had a negative impact on the adolescent birth rate by 2.5-2.8 births per thousand adolescents aged 15-19 (a 4 percent decrease from the preintervention average). Additionally, we exploited variation in reform implementation intensity through the estimation of fixed-effect linear regression models and found consistent results. Our findings are robust to controlling for a concurrent large-scale program of contraceptive implants. We conclude that legislation aimed at enhancing rights and reducing avoidable deaths and complications from unsafe abortions may also have spillover effects that help reduce adolescent fertility.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"491-514"},"PeriodicalIF":2.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40404716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraceptive Use in Urban Africa: Examining Trends in Rich-Poor Gaps.","authors":"Alex Ezeh,&nbsp;Maurice Anyawie,&nbsp;John Cleland","doi":"10.1111/sifp.12205","DOIUrl":"https://doi.org/10.1111/sifp.12205","url":null,"abstract":"<p><p>Previous studies have documented significant differences in health and reproductive health outcomes between the poor and nonpoor across various countries in sub-Saharan Africa. However, a number of these studies is dated, and the past decade has witnessed significant shifts in health and reproductive health outcomes in many African countries. Using recent data from the Demographic and Health Surveys, this paper updates and extends the literature by examining patterns in contraceptive practice among poor and nonpoor married women in urban settings in 19 African countries. First, we analyze changes in the rich-poor gaps in modern contraceptive prevalence (mCP) in urban Africa over time. We then determine the public source of the supply of modern contraceptives to the urban poor and how that supply may have changed over a 10-year period. The findings show that, in most Eastern and Southern African countries, previous gaps in mCP between the rich and poor married women have disappeared. Countries in Central and Western Africa, however, continue to have significant gaps in mCP between rich and poor women, with urban poor women experiencing only a modest improvement in mCP over the past decade. This paper contributes to our understanding about sub-regional dynamics in reproductive health outcomes in urban settings in sub-Saharan Africa.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"515-526"},"PeriodicalIF":2.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40400350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraceptive Use Before and After Abortion: A Cross-Sectional Study from Nigeria and Côte d'Ivoire.","authors":"Sophia Magalona,&nbsp;Meagan Byrne,&nbsp;Funmilola M OlaOlorun,&nbsp;Rosine Mosso,&nbsp;Elizabeth Omoluabi,&nbsp;Caroline Moreau,&nbsp;Suzanne O Bell","doi":"10.1111/sifp.12208","DOIUrl":"https://doi.org/10.1111/sifp.12208","url":null,"abstract":"<p><p>Post-abortion contraception enables women to effectively manage their fertility to prevent unintended pregnancies. Using data from population-based surveys of women aged 15-49 in Nigeria and Côte d'Ivoire, we examined contraceptive dynamics immediately before and after an abortion and examined factors associated with these changes using multivariable logistic regressions. Covariates included sociodemographic characteristics, abortion source, post-abortion contraceptive communication (wanting to and actually talking to someone about contraception after abortion), and perceived contraceptive autonomy. We observed higher contraceptive use after abortion than before abortion. In Nigeria, wanting to talk to someone about contraception post-abortion was associated with increased adoption and decreased discontinuation, whereas talking to someone about contraception post-abortion was associated with increased adoption. Obtaining care from a clinical abortion source was associated with increased adoption and decreased discontinuation. Both post-abortion contraceptive communication variables were associated with post-abortion contraceptive use in both countries, whereas clinical source was only associated with post-abortion contraceptive use in Nigeria. Our findings suggest that ensuring that women have access to safe abortion as part of the formal health care system and receive comprehensive, high-quality post-abortion care services that include contraceptive counseling enables them to make informed decisions about their fertility that align with their reproductive goals.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"433-453"},"PeriodicalIF":2.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9545736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40631326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and Enablers Influencing Women's Adoption and Continuation of Vaginally Inserted Contraceptive Methods: A Literature Review.","authors":"Danielle M Harris,&nbsp;Anita Dam,&nbsp;Kate Morrison,&nbsp;Chastain Mann,&nbsp;Ashley Jackson,&nbsp;Shannon M Bledsoe,&nbsp;Andrea Rowan,&nbsp;Kim Longfield","doi":"10.1111/sifp.12209","DOIUrl":"https://doi.org/10.1111/sifp.12209","url":null,"abstract":"<p><p>Most vaginally inserted methods have limited availability and use despite offering characteristics that align with many women's stated preferences (e.g., nonhormonal and/or on demand). The objective of this review was to identify enablers and barriers to women's adoption and continuation of vaginally inserted contraceptive methods in low- and middle-income countries (LMICs). We searched three databases (PubMed, Embase, and Web of Science) and 18 websites using keywords related to five vaginally inserted contraceptive methods (diaphragm, vaginal ring, female condom, copper intrauterine device [IUD], hormonal IUD) and terms associated with their adoption and continuation. Searches were limited to resources published between January 2010 and September 2020. Studies eligible for inclusion in our review presented results on women's use and perspectives on the enablers and barriers to adoption and continuation of the vaginally inserted contraceptive methods of interest in LMICs. Relevant studies among women's partners were also included, but not those of providers or other stakeholders. Data were coded, analyzed, and disaggregated according to a framework grounded in family planning (FP) literature and behavioral theories common to FP research and program implementation. Our initial search yielded 13,848 results, with 182 studies ultimately included in the analysis. Across methods, we found common enablers for method adoption, including quality contraceptive counseling as well as alignment between a woman's preferences and a method's duration of use and side effect profile. Common barriers included a lack of familiarity with the methods and product cost. Notably, vaginal insertion was not a major barrier to adoption in the literature reviewed. Vaginally inserted methods of contraception have the potential to fill a gap in method offerings and expand choice. Programmatic actions should address key barriers and enable voluntary use.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"455-490"},"PeriodicalIF":2.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/22/81/SIFP-53-455.PMC9545114.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40678788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Child Marriage, Reproductive Outcomes, and Service Utilization among Young Afghan Women: Findings from a Nationally Representative Survey in Afghanistan.","authors":"Omid Dadras,&nbsp;Tanaporn Khampaya,&nbsp;Takeo Nakayama","doi":"10.1111/sifp.12207","DOIUrl":"https://doi.org/10.1111/sifp.12207","url":null,"abstract":"<p><p>This study explored the prevalence of child marriage and its association with reproductive outcomes and service utilization among young women in Afghanistan. We conducted a secondary analysis of data from the 2015 Afghanistan Demographic and Health Survey (DHS), focusing on women aged 20-24 years old based on the United Nations' recommendation on child marriage study. Multivariate logistic models examined the association between child marriage, reproductive outcomes, and service utilization. An estimated 52% of the Afghan women aged 20-24 married at ages less than 18 years. Poverty and illiteracy were associated with the higher likelihood of early marriage. There was a significant negative relationship between child marriage and history of rapid repeat childbirth, delivery by skilled personnel, and institutional delivery. In both adjusted and unadjusted models, women married at age ≤14 were more likely to experience terminated or unintended pregnancy, inadequate ANC, unmet need for family planning, and fistula; while, for those married at age 15-17 years, only terminated or unintended pregnancy remained significant. Strict international law enforcement and advocacy are needed in the current situation of Afghanistan to increase young women's education, promote their civil rights, and improve their autonomy and role in decision-making concerning their fertility preferences and reproductive health.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"417-431"},"PeriodicalIF":2.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40268676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fertility Preferences and Contraceptive Change in Low- and Middle-Income Countries.","authors":"Mobolaji Ibitoye,&nbsp;John B Casterline,&nbsp;Chenyao Zhang","doi":"10.1111/sifp.12202","DOIUrl":"https://doi.org/10.1111/sifp.12202","url":null,"abstract":"<p><p>The past four decades have witnessed an enormous increase in modern contraception in most low- and middle-income countries. We examine the extent to which this change can be attributed to changes in fertility preferences versus fuller implementation of fertility preferences, a distinction at the heart of intense debates about the returns to investments in family planning services. We analyze national survey data from five major survey programs: World Fertility Surveys, Demographic Health Surveys, Reproductive Health Surveys, Pan-Arab Project for Child Development or Family Health, and Multiple Indicator Cluster Surveys. We perform regression decomposition of change between successive surveys in 59 countries (330 decompositions in total). Change in preferences accounts for little of the change: less than 10 percent in a basic decomposition and about 15 percent under a more elaborate specification. This is a powerful empirical refutation of the view that contraceptive change has been driven principally by reductions in demand for children. We show that this outcome is not surprising given that the distribution of women according to fertility preferences is surprisingly stable over time.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"53 2","pages":"361-376"},"PeriodicalIF":2.1,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9219575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10526921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Family Planning Counseling on Incident Pregnancy in Nepal.","authors":"Muqi Guo,&nbsp;Sarah Huber-Krum,&nbsp;Iqbal Shah,&nbsp;David Canning","doi":"10.1111/sifp.12197","DOIUrl":"https://doi.org/10.1111/sifp.12197","url":null,"abstract":"<p><p>An intervention aimed at institutionalizing postpartum intrauterine device (PPIUD) services was introduced in Nepal between 2015 and 2019. The intervention was evaluated using a cluster-randomized stepped-wedge trial, with data on women being collected immediately after delivery and at one- and two-year postpartum follow-ups. The sample consists of 19,155 women. We used intention-to-treat (ITT) analysis and structural equation model (SEM) to investigate how the intervention affected the occurrence of a new pregnancy (incident pregnancy). The ITT analysis showed that women in the intervention group had a reduced probability, -0.7 percentage points (95 percent CI: -3.0, 1.4), of having an incident pregnancy compared to women in the control group. The SEM analysis showed that the intervention increased the probability of receiving antenatal family planning counseling and PPIUD-specific counseling by 22.2 percentage points (95 percent CI: 20.0, 24.4) and 26.5 percentage points (95 percent CI: 24.8, 28.3), respectively. The intervention had an unintended spillover effect, increasing the probability of receiving postnatal family planning counseling by 11.4 percentage points (95 percent CI: 7.3, 15.5). In the SEM, we find the expected impact of the intervention on increased counseling and induced effects on contraceptive method initiation, lowering the probability of an incident pregnancy by 0.3 percentage points (95 percent CI: -0.5, -0.1).</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"315-338"},"PeriodicalIF":2.1,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40121306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A \"Plus\" Model for Safe Transitions to Adulthood: Impacts of an Integrated Intervention Layered onto A National Social Protection Program on Sexual Behavior and Health Seeking among Tanzania's Youth.","authors":"Jennifer Waidler,&nbsp;Ulrike Gilbert,&nbsp;Aroldia Mulokozi,&nbsp;Tia Palermo","doi":"10.1111/sifp.12190","DOIUrl":"https://doi.org/10.1111/sifp.12190","url":null,"abstract":"<p><p>Poverty is a structural driver of risky sexual behaviors. While cash transfers can mitigate some of this risk, complementary interventions have been posited as a way to further reduce multidimensional vulnerability. We examine the impacts of a multicomponent intervention targeted to Tanzanian adolescents on their sexual behaviors and reproductive health. The intervention comprised livelihood and life skills training, mentoring, and health facilities' strengthening. Data come from a cluster randomized controlled trial, where one study arm received the intervention and the other was randomized to control, but both arms participated in a government cash transfer program. Among 1,933 adolescents interviewed over three rounds, we found increases in contraceptive and HIV knowledge. The program also increased health seeking and HIV testing among boys, but slightly reduced age at sexual debut among girls. There were no impacts on contraceptive use, number of sexual partners, or pregnancy. Findings support the value of an adolescent intervention, and the fact that it was delivered within a social protection platform suggests a potential for scalability. Additional efforts are required to delay sexual debut and reduce the number of sexual partners and pregnancy, possibly through addressing supply-side barriers and social norms, or through additional linkages to economic opportunities.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"233-258"},"PeriodicalIF":2.1,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40311700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the Trump Administration's Expanded Global Gag Rule Policy on Family Planning Service Provision in Ethiopia","authors":"Elizabeth A. Sully, S. Shiferaw, A. Seme, S. Bell, Margaret Giorgio","doi":"10.1111/sifp.12196","DOIUrl":"https://doi.org/10.1111/sifp.12196","url":null,"abstract":"Abstract The Global Gag Rule (GGR) makes non‐U.S. nongovernmental organizations (NGOs) ineligible for U.S. Government global health funding if they provide, refer, or promote access to abortion. This study quantitatively examines the impacts of the GGR on family planning service provision in Ethiopia. Using a panel of health facilities (2017–2020), we conduct a pre–post analysis to investigate the overall changes in family planning service provision before and after the policy came into effect in Ethiopia. Our pre–post analyses revealed post‐GGR reductions in the proportions of facilities reporting family planning provision through community health volunteers (−5.6, 95% CI [−10.2, −1.0]), mobile outreach visits (−13.1, 95% CI [−17.8, −8.4]), and family planning and postabortion care service integration (−4.8, 95% CI: [−9.1, −0.5]), as well as a 6.1 percentage points increase in contraceptive stock‐outs over the past three months (95% CI [−0.6, 12.8]). We further investigate the impacts of the GGR on facilities exposed to noncompliant organizations that did not sign the policy and lost U.S. funding. We do not find any significant additional impacts on facilities in regions more exposed to noncompliant organizations. Overall, while the GGR was slow to fully impact NGOs in Ethiopia, it ultimately resulted in negative impacts on family planning service provision.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"53 1","pages":"339 - 359"},"PeriodicalIF":2.1,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47781288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}