PMA2020 uses innovative mobile technology to support low-cost rap¬id-turnaround surveys to monitor key indicators for family planning. The project is implemented by local university and research organiza¬tions in 11 coountries deploying a cadre of female resident enumerators trained in mobile-assisted data collection. This brief includes graphically presented data on select family planning indicators across recent surveys (women in union and all women ages 15-49); fertility indicators (all women ages 15-49); current use and unmet need among women in union of reproductive age by wealth tertile; unmet need and contraceptive use by age (all women); Modern contraceptive prevalence rate 2003-2016 (women ages 15-49); current modern method mix among contraceptive users in union; current modern method mix among unmarried sexually active contraceptive users; for current modern contraceptive users (%) indicators by wealth tertiles (%); birts in the past 5 years or current pregnancies; for current female non-users: reasons mentioned for non-use among all women wanting to delay the next birth 2 or more years (%); reproductive health and contraceptive indicators; percent of public facilities offering at least 5 modern contraceptive methods by facility type; and service delivery points; Fertility Indicators (All Women Ages 15-49); Fertility Indicators (All Women Ages 15-49); Select Family Planning Indicators Across Recent Surveys (Women in Union and All Women Ages 15-49); Select Family Planning Indicators Across Recent Surveys (Women in Union and All Women Ages 15-49).
Nutrition is a direct contributor and target to Sustainable Development Goal 2 (“End hunger achieve food security and improved nutrition and promote sustainable agriculture”) a foundation and pre-requisite to Sustainable Development Goal 3 (“Ensure healthy lives and promote well-being for all at all ages”) and a decisive enabler to the remaining goals of the Sustainable Development Agenda 2030. The World Health Organization (WHO) supports all Member States to achieve “a world free of all forms of malnutrition where all people achieve health and well-being” a vision supported by our work with Member States and their partners to ensure universal access to effective nutrition actions and to healthy and sustainable diets1 in the context of the overall effort to ensure universal health coverage2. To do this WHO uses its convening power to help facilitate and align priority setting to mainstream nutrition in the health and development agenda; develop evidence-informed guidance supported by the highest quality science and ethical frameworks; support the adoption of guidance its implementation and the integration of effective actions into existing or new delivery platforms in the health systems. WHO guidelines are documents developed by WHO containing recommendations for clinical practice or public health policy and programmes. A recommendation tells the intended end-user of the guideline what he or she can or should do in specific situations to achieve the best health and nutrition outcomes possible individually or at the population level. It offers a choice among different interventions or measures having an anticipated positive impact on health and nutrition and implications for the use of resources.3 The WHO Department of Nutrition for Health and Development (NHD) develops guidelines in accordance with the procedures established in the WHO Handbook for Guideline Development.2 The WHO guideline development process ensures that WHO guidelines are of high methodological quality and are developed through an independent transparent evidence-informed consensual decision-making process. Though the process with which WHO develops guidelines is highly structured systematic and transparent the process for priority setting (i.e. prioritizing topics4 for guideline development) has been a dynamic one in order to accommodate new and renewed high-level commitments from the WHO Secretariat as well as emerging issues arising from discussions among Member States in the Governing Body fora such as the World Health Assembly (WHA). The priority issues are determined by their importance (i.e. magnitude prevalence and distribution of disease or nutrition problems) or the existence of preventable or modifiable biological behavioural and contextual determinants (risk factors). Updating guidelines is challenging if evidence has to be retrieved to support an increasing number of recommendations. In this situation it is important to give priority to assuring the principle of “primum non nocere” (first do no harm) to address controversial areas and to set a position on areas in which new evidence has emerged and requires prompt action. Ensuring a well-understood and efficiently communicated prioritization process is therefore crucial as external partners and stakeholders play an important role in the WHO guideline implementation process. Independence and transparency of the prioritization process gives the Organization a means of providing assurance that the process is free of any undue influence that may affect the reputation and objectivity of WHO. Therefore in an effort to maintain transparency in the normative work of WHO and to enhance the understanding of the process used to prioritize topics for guideline development among Member States and stakeholders the Department of Nutrition for Health and Development (NHD) is leading the work on making the prioritization process more accessible and has developed an online tool to further facilitate the participation of Member States and their stakeholders in the guideline prioritization process. This process aims to complement the decisions of the World Health Assembly (WHA) the decision-making body of WHO. (Excerpts
This study examines perceptions of institutional delivery among married couples and older women in the Tangkhul Nagas tribe living in two villages of Ukhrul district Manipur India. One village has a Primary Health Center with good road connectivity only 25 kilometers from the capital city of Manipur. The other village is located in an isolated area of the hilly region with no modern amenities or infrastructure. The nearest health facility is 10 kilometers away. Findings indicate a resistance to the insistence on Caesarean section deliveries by health professionals and a preference for traditional birth attendants.
This article focuses on the planned family planning effort in India through the establishment of the National Family Planning Programme in 1977 which was renamed into National Family Welfare Programme.
Family planning has been at the very centre of planned development with an emphasis on extension education approach for motivating people for acceptance of the small family norm. The programme has traditionally sought to promote responsible and planned parenthood through voluntary and free choice of family planning methods best suited to individual acceptors.1 Female sterilization is the most popular method of contraception in India. NFHS 1 2 and 3 have reported that female sterilization accounted for 67% 71% and 77% of the total contraceptive use respectively.24 NFHS-3 further reported that female sterilization was the most widely known method among women (97%) and men (95%) and nearly two-thirds (64%) of prospective users said they would prefer female sterilization.4 The decision about use of any contraceptive method is to be made voluntarily hence understanding the decision making process regarding the use of contraception becomes very important. This study was conducted to understand the factors affecting the decision-making process for the acceptance of tubectomy. (excerpt)
The birth rate in India has been high since many decades. Decreasing infant mortality decreasing child mortality and longer expectancy of life has led to an annual population growth of 1.8. In 2011 the population of India counts 1.21 billion people.1 Use of effective contraception is one of the most important methods in achieving the goal of a Total Fertility Rate (TFR) of 2. in India (replacement level of fertility) and achieving population stabilization. In order to achieve the goals of its Population Policy different initiatives have been launched by the Indian government. One of these is promoting contraceptive use through free contraception distribution through local health services and monetary incentives for sterilization. Moreover the Indian government seeks to address the unmet need of contraception in the Indian population. Unmet need refers to ...the need of women and couples who wish to control their fertility but use no method. Overall the unmet need for contraception in India is 16.1 percent; hereof 8.3 percent for reversible methods. However 98 percent of the need for permanent methods is being met while only one-third of the need for spacing methods is being met. Knowledge of contraception is nearly universal in India. Among the methods available female sterilization an irreversible contraceptive method is known by almost everybody whereas other modern reversible contraceptive methods (MRCMs) are less known. Overall the use of contraception has risen in India from 13 percent in 1970 to 53 percent in 2002-2004. Regarding the use of different contraceptive methods statistics reveal that female sterilization the method which most people know is the method which is most widely used for family planning. The use of female sterilization has increased from 27.3 percent in 1992-93 to 34.3 percent in 2002-04. The use of MRCMs is much lower: use of oral pill was 3.5 percent use of Intra-Uterine Devices (IUD) was 1.9 percent in 2002-04 and use of the condom was 4.8 percent in 2002-04. The National Population Policy of India states that the Indian government is committed towards voluntary and informed contraceptive choice but that given the high rate of female sterilization and low use of MRCMs it is concluded that informed and expanded choice has not yet become a reality. Although knowledge and use of MRCMs has increased the use is still low especially in rural areas. It is important for both men and women to get access to accurate information about different available contraceptive methods including MRCMs in order to make informed choices. Most importantly people in need of contraception should have access to the method most appropriate for their situation. Therefore it is relevant to examine the barriers that keep people living in rural settings from using MRCMs. The objective of this paper is to identify major barriers that keep people in rural areas from using MRCMs and user and policy level recommendations which can be implemented in order to assess the barriers and thus increase the use of MRCMs. (excerpt)
This study explores the psychological problems faced by women who had undergone abortion in a community-based ethnographic study in five villages of Haryana India.
Teenage mothers are at greater risk of social and economic disadvantage throughout their lives than those who delay childbearing until their twenties. Teenage mothers are less likely to complete their education to be employed to earn high wages and to be happily married and are more likely to have large families. Path-breaking early research reported large negative effects of early childbearing on educational attainment after controlling for a variety of individual and family background factors. The reproductive behaviour of an adolescent woman is influenced by the attitude and behaviour of her parents kin and the societies at large. As most adolescent girls are illiterate they lack knowledge of family planning methods. Even if they are aware of contraceptives they do not have access or are not able to utilize them. It is due to the fact that as soon as they are married they are under tremendous pressure to attain motherhood to satisfy their mother-in-law or husband. Therefore the study on fertility behaviour among adolescents acquires special importance in the context of India where the high rate of adolescent marriage is caused due to low level of female education. The specific objectives of this study are to: a) analyze the proximate determinants of adolescent fertility in major states of India b) examine the inter-state variations in adolescent fertility in India and c) identify the principal determinants of adolescent fertility in India.
In October 2009 the Population Council conducted a formative study in Rural Uttar Pradesh with the following objectives: (a) to explore the current status and postnatal care practices for mothers and newborns including care seeking for complications; (b) to identify the barriers and factors facilitating the adoption of healthy postnatal care practices; (c) to identify programmatic and behavior change communications (BCC) initiatives that could accelerate the adoption of healthy postnatal care practices. (Excerpt)
In the context of increasing input under the NRHM and the proposed behavior change communication (BCC) activities in 2010 the International Institute for Population Sciences (IIPS) a partner in the Population Council-led consortium conducted a study to assess: a) the expected increase in workload of public health facilities in providing various MCH services until 2015 b) the extent to which this increased demand could be met by the existing network of health facilities.
Generally self help groups (SHGs) are formed to alleviate poverty. Groups of individuals who are below the poverty line are given micro credit for generating income through small income-generating activities. This is based on the largely successful model developed by Muhammad Yunus of the Grameen Bank in Bangladesh which had spread widely in the mid 1990s giving promise of alleviating rural poverty at the same time increasing empowerment of women through income-generating activities. This paper presents information about a programme for generating womens self-help groups (SHGs) in rural Bellary district in eastern Karnataka. During the period from 2000 to 2008 the Family Planning Association of India (FPA India) Bellary branch carried out a programme aimed at developing self-help groups among rural women in one of their service area (Bellary taluka). The programme was carried out with training support from the nearby Agricultural University the District Industries Corporation (a Karnataka state agency) and a Karnatakabased NGO the Mysore Resettlement and Development Agency (MYRADA). State and Central governmental programmes for supporting micro-finance and income generating programmes under the Women Development Corporation (WDC) (Karnataka State) were sources of funding for the SHG campaign.
The Journal of Family Welfare IntroductIon Health care seeking behavior is the first step towards the cure of any health problem. There has been evidence that due to lack of motivation to seek help, many of the health problems remain untreated in the world even though services are available at the doorstep. A study revealed that health care seeking behavior is deeprooted within the political, economic, and cultural context as well as specific social relations.1 The sequence of curative actions that an individual seeks to cure perceived ill health is known as health seeking behavior.2-3 However, health care seeking behavior is itself determined by a large number of factors.
An empirical study on the impact of birth control on fertility rates in sub-Saharan Africa was carried out using cross-country data and a multiple regression analysis. Of all the birth control devices considered in this study only the withdrawal method ran contrary to our apriori expectation thus indicating that it did not have much influence in reducing fertility rate in sub-Saharan Africa. That the other devices (pills injection intra uterine device (IUD) condom/diaphragm and cervical cap female sterilization and periodic abstinence/rhythm) fulfilled our apriori expectations does not mean that efforts should not be made to improve and sustain its usage thus the governments in the sub-region must continue to show commitment in the implementation of their policies on birth control and make sure that the implementation go hand-in-hand with enough enlightenment campaigns on the benefits of birth control. (excerpt)
Violence against women has serious consequences on the physical and mental health of women and the urgent need to address the issue needs no emphasis. It is a major public health problem and a violation of the rights of women. Available studies indicate that 16-50 percent of women face violence in their lifetime. In patriarchal societies particularly in South-Asian countries the situation is much worse as violence against women is an accepted norm for controlling them. In countries like Bangladesh the problem is compounded by extreme poverty illiteracy and early marriage. What makes it very difficult to respond effectively to gender based violence is the fact that even today domestic violence is treated as a normal part of married life by both men and women. For programmatic interventions to address such culturally deep-rooted problems detailed and reliable information on the prevalence nature and causes of gender violence in the given context is critical. One such effort is a WHO multi-country study which also covers Bangladesh. The present paper is one such attempt to understand the dynamics of gender based violence in Bangladesh. (excerpt)
