birth control
Evaluation of Chinese population control in the past decade and the countermeasures in the future.

Wei J.

PIP: This commentary is a preliminary review of Chinese population control between 1978-88 and future choices. There is discussion of new problems in population control, new experiments in population control, and the beneficial impact of population control. Control of the population was more effective from 1979 to the present than from 1973-1978. Figures reflect the patterns of age of 1st marriage, marriage rate, fertility rate, single child rate, birth rate, and natural growth rate. Problems are identified as the increase in rural household size and the failures of rural economic reform which stressed responsibility. Age structure also has had an effect. Rural households have changed so that increases have occurred and weakened the population control system. Discussion proceeds with some detail on the changes in household needs, changes that correspond to household size, and the weakening of the population control system. New experiments in population control have occurred in the responsibility systems, through the combination of a strict strategy and flexible tactics, and with the establishment of an extensive network of family planning (FP) departments, which have received increased funding over the years. There has been a strategy of combining and coordinating birth control practice, publicity, and education. Publicity has consisted of both information stressing the necessity of FP and government policies, and knowledge about population theories and birth control. FP techniques are used as appropriate to specific populations; i.e., married, unmarried, newly married, pregnant, or those having recently conceived. Publicity and education are combined with birth control services. Publicity and education also are integrated with the establishment of socialist values. 4 variables that determine the fertility rate have been identified: bachelorhood or spinsterhood, contraception, abortion, and breastfeeding and sterility. These have contributed to the drop in fertility to a current rate of 2.4. There has also been a system of rewards and restrictions to encourage mature age marriage and pregnancy, and the practice of birth control. The beneficial impact is considered in terms of the impact on rapid growth of the population, the improvement in the age structure, the promotion of continuous social development, and the simultaneous success of economic development with fertility decline. Future suggestions are to adopt a policy system and development program that integrates population, social, economic, resource, and environmental elements, and to establish a new population control system which regulates household needs for reporduction and thereby indirectly guides household reproductive behavior. A new self checking mechanism is required which increases the costs of raising children.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12316995&dopt=Abstract birth control



birth control
[Propaganda work is still a weak link in rural family planning]

[Article in Chinese]

Zhong S.

PIP: The Population Institute of Wuhan University in China conducted a field study on the family planning (FP) program in several cities and counties of Hubei Province in 1989. It was found that a number of aspects of the program were incompatible with what was needed to deal with the eminent population growth. 1) There was a shortage of FP personnel at the grassroots level. Those who were responsible for the FP program were often too busy with other things or did not have sufficient knowledge or experience for the job. 2) Publicity about the government FP policy was inadequate in many local areas. Out of 1,263 women with 2 or more children who responded to the study, only 5.3% had heard about the policy, 26.7% never read about FP and 43.7% never thought about the government birth control policy when trying to become pregnant. 3) Knowledge about birth control methods was in adequate for the needs of the people. 85% of the respondents knew about birth control methods, basically the IUD and female sterilization. Only 14.4% knew about oral contraceptives, 1.8% about vasectomy, and 1% about injectables. Knowledge of the rest of the methods was no more than 1%. Even local FP workers did not know much more. For those women who did not want to use surgical procedures, no alternatives were known. Therefore, no contraceptive method was used, thus unwanted pregnancies occurred. 4) Some methods of FP publicity in rural areas were overly simplistic. To some local FP workers, publicity only meant writing slogans with FP messages on the wall. Quite a few local workers did not know FP policies and regulations. They simply said "You have to pay a fine if you have too many children," making people believe that the FP program was no more than a way to collect money. The information gathered from the survey showed that publicity and education are of great importance to a FP program. They can either help the program implementation or cause adverse effects.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12317525&dopt=Abstract birth control



birth control
The effectiveness of family planning programs in less developed countries: the evidence from survey data.

Kirk D.

PIP: 25 countries in the less developed world now have functioning family planning programs designed to promote the practice of birth control. Their effectiveness is difficult to assess. Knowledge, attitudes, and practices (KAP) studies are one means of program evaluation. A great deal of information is available from these studies. All populations show more awareness, approval, and practice of birth control. The programs have been able to get large numbers of people to use their promoted methods and are reaching large numbers of women in high fertility groups. Surveys indicate that ideas of ideal family size and composition are resistant to change thus making birth control acceptance more difficult to achieve. Methodological weaknesses in KAP studies are lack of information on intensity of motivations and attitudes about birth control, inconsistency in responses, and failure of respondent to understand questions. They are still not a completely reliable measure of the direct effects of family planning programs and tend to exaggerate the program's demographic impact. Survey and evaluation efforts have underplayed the role of abortion. Family planning programs will continue to play an important role in reducing births, but socio-economic factors will have more effect.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12305820&dopt=Abstract birth control



birth control
Latin American attitudes on birth control: a typology.

Mundigo A.

PIP: A survey of Honduran elites consisting of 300 government, business, industrial and professional leaders and 400 university students, was undertaken to determine the sources of negative and positive influences on birth control in order to outline a typology of opinions covering the entire range of attidues toward this issue. Major sources of negative influence are the Roman Catholic Church, political parties, and the universities. The support of this issue is also encountered along the entire political spectrum, mainly the centralist and rightist positions, with the most vocal support coming from the Family Planning Association. The paper describes the view of the various groups and then arranges the elite's opinions on birth control into a typology.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12305866&dopt=Abstract birth control



birth control
Beliefs about birth control: a consistency theory analysis.

Crawford TJ.

PIP: 201 lower income women aged 20-40 were interviewed in a large midwestern city in December 1967 and January 1968 to determine attitudes towards, beliefs about, and use of birth control. Those who approved of birth control had more positive beliefs about the consequences of birth control than those with less favorable attitudes. Users of reliable methods also held more positive attitudes about birth control consequences than nonusers or users of nonreliable methods although this relationship was weak. Strategies for improving family planning behavioral predictions are suggested as well as implications of this for family planning communication programs.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12306857&dopt=Abstract birth control



birth control
Birth control, sterilization, and abortion.

Schneiderman LJ, Prichard L, Fuller S, Atkinson L.

PIP: 27 Catholics and 27 Protestant clergymen in the San Diego area were given an attitude questionnaire on birth control, sterilization, and abortion in families with specific genetic problems. Results showed that a) the majority, although not all, of the clergymen follow the official positions of their churches in these matters, b) Protestant clergymen were more likely than Catholic clergymen to approve of birth control, abortion and sterilization, and c) the approval responses of clergymen were not greatly influenced by whether the illness variables involved high Mendelian risk, high psychological cost, high social cost, or poor prognosis. The approval responses were not significantly influenced by the socioethnic backgrounds of the families.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12307235&dopt=Abstract birth control



birth control
Pregnancy and birth control counseling.

Canfield E.

PIP: The Los Angeles Free Clinic has provided both pregnancy and birth control counseling to individuals seeking information not easily obtained from conventional medical channels. In terms of pregnancy counseling, the clinic conducted sessions which offered emotional support and provided a pelvic examination in order to confirm an intrauterine pregnancy. If pregnancy had not been confirmed, contraception was recommended until the diagnosis was made. Following this, a full explanation of alternatives was made with as little personal bias as possible -- abortion, pregnancy continuation, and physical risks associated with either of these choices. After presentation of options, the counselor conducted a discussion in order to cover the pertinent problems of the particular group. 1st, each woman presented her individual situation to the group. While discussing the problems inherent in attitudes toward sexuality, the counselor tried to redefine responsible sexual behavior as an involvement with planning, forethought, and concern for partners. It is also necessary for the counselor to try to get the women to make a decision on their next step. The birth control counseling was also held in groups but in separate sessions from the pregnancy counseling. Pregnancy and birth control counselors should be selected on the basis of the following criteria if they are to be helpful and effective: intelligence, comfortable approval and acceptance of one's own sexuality, ability to provide information rather than advice, openness to change and new ideas, the ability to be supportive of a client's choice even though it might appear to be unwise to the counselor, and the qualities of sensitivity, empathy, and a nonneurotic desire to help others.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12308775&dopt=Abstract birth control