Back to home page1993 - VOLUME 19, NUMBER 2
93.76.09 - English - I.O. ORUBULOYE, Faculty of the Social Sciences, Ondo State University, Ado-Ekiti (Nigeria), Pat CALDWELL and John C. CALDWELL, Health Transition Centre, Australian National University, Canberra (Australia)
The Role of High-risk Occupations in the Spread of AIDS: Truck Drivers And Itinerant Market Women in Nigeria (p. 43-48, 71)
A study of 258 truck drivers and 467 itinerant female hawkers in Ibadan, Nigeria, reveals that occupational demands have resulted in a network of multiple sex partners that may spread AIDS to and through Nigeria. Although 78% of the truck drivers are currently married, only 5% report having no regular sex partners besides their wife. The drivers say they have an average of six regular sex partners, about one woman at each of their overnight stops. During the year prior to the 1991 interview, the drivers report having an average of 12 partners besides their wife, and the lifetime number of partners is 25. 44% of the drivers have been treated for a sexually transmitted disease (STD). Nearly all drivers have heard of AIDS, but only 15% use condoms regularly. The female hawkers, who sell a wide variety of goods at truck stops, average 20 years of age and report their median age at onset of sexual activity to be 14. Most of the women are single, 95% are sexually experienced, and half acknowledge supplementing their income from hawking goods by providing sex for money. More than 20% report having had an STD. (NIGERIA, AIDS, OCCUPATIONS)
93.76.10 - English - David HUBACHER and Linda POTTER, Family Health International, Research Triangle Park, NC (U.S.A.)
Adherence to Oral Contraceptive Regimens in Four Countries (p. 49-53)
Results from Demographic and Health Surveys conducted in Botswana, Egypt, Indonesia and Zimbabwe between 1987 and 1989 show that many women are not taking oral contraceptives properly or adequately for full protection. Depending on the country and the particular type of pill-taking error, the prevalence of incorrect use among current users ranges from 5% to 89%. However, relationships between pill-taking errors and social and demographic variables differ across countries: Incorrect use is most common in Egypt, for instance, and errors there are concentrated among poorly educated and illiterate women, while in Botswana, better educated and literate women are more likely to make errors in pill-taking, as are younger and lower parity women. In Zimbabwe and Indonesia, such errors are not concentrated in any particular social or demographic groups. (ORAL CONTRACEPTIVES, CONTRACEPTIVE USAGE)
93.76.11 - English - Lorenzo MORENO, Mathematica Policy Research, Princeton, NJ (U.S.A.)
Differences by Residence and Education in Contraceptive Failure Rates in Developing Countries (p. 54-60, 71)
A study based on Demographic and Health Survey data from 15 countries in Latin America, Asia and North Africa shows that the contraceptive method selected, the duration of use and the age of the woman are important determinants of the probability of failure in the first year. In addition, women who want to postpone their next birth seem to have higher failure rates than women who wish to limit their family size. The study found little evidence that rural women use contraceptives less effectively than do urban women or that user effectiveness rises with level of education. (DEVELOPING COUNTRIES, CONTRACEPTION FAILURES)
1993 - VOLUME 19, NUMBER 3
93.76.12 - English - Jane T. BERTRAND, Nancy D. BAUGHMAN, Tulane University School of Public Health and Tropical Medicine, New Orleans (U.S.A.), Mark E. McBRIDE, Department of Economics, Miami University, Oxford, Ohio (U.S.A.), Nlandu MANGANI, Integrated Family Health Services Project, Bamako (Mali), and Mombela KINUANI, Project des Services des Naissances Désirables, Kinshasa (Zaire)
Community-based Distribution of Contraceptives in Zaire (p. 84-91)
The operations research component of a community-based distribution project in Zaire during the 1980s found that the average number of couple-months of contraceptive protection per month provided by each distributor varied widely across the project's eight sites, from 204 in Miabi to 1,310 in Matadi. Within each site, the average performance of distributors remained constant during the life of the project,. increases in contraceptive sales were achieved by adding distributors to the system. The only significant predictors of distributors' performance were age and project site (reflecting local demand for contraception and managerial efficiency). Costs per couple-month of protection declined over time, reflecting increases in output rather than decreases in project costs. Costs per couple-year of protection were high by international standards - $29 in the project sites that had been in operation eight years and much more in the newer sites. The proportion of married women using modem contraceptives increased at each site during the project,. in the city of Matadi, that proportion rose from 4% in 1981 to 23% in 1989. The project was integrated into the government family planning program, but activities at most sites were disbanded in the early 1990s because of political turmoil and erratic funding. (ZAIRE, FAMILY PLANNING PROGRAMMES, CONTRACEPTIVE DISTRIBUTION)
93.76.13 - English - Karungari KIRAGU and Laurie S. ZABIN, The Johns Hopkins School of Hygiene and Public Health, Baltimore (U.S.A.)
The Correlates of Premarital Sexual Activity among School-age Adolescents in Kenya (p. 92-97, 109)
About 3,000 adolescents enrolled in 46 coeducational primary, secondary and vocational schools in Kenya were surveyed in 1989 to investigate factors associated with premarital sexual behavior. Depending on the type of school, 48-77% of the males report ever having had coital experience, compared with 17-67% of the females. Nearly half the sexually experienced males report multiple sex partners. A multiple regression analysis of the secondary school subsample shows that males who socialize with sexually experienced peers are nearly seven times as likely as those whose peers are not sexually experienced to have had sex themselves; similar females are three times as likely to have had sex. Young women who report substance use are more than four times as likely as those who do not to be sexually experienced, and males who do so are almost twice as likely. Other correlates of sexual experience include residing in a rural area, having attained puberty, having weak religious commitment, holding attitudes tolerant of premarital sex, having an unstable family environment and, among males, attending a boarding school. Neither reproductive health knowledge nor socioeconomic status are significantly associated with sexual behavior. (KENYA, ADOLESCENTS, SEXUAL BEHAVIOUR)
93.76.14 - English - Jane E. MILLER, Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ (U.S.A.)
Birth Outcomes by Mother's Age at First Birth in the Philippines (p. 98-102)
Data on 2,063 newborns from the 1983-1984 Cebu (Philippines) Longitudinal Health and Nutrition Survey show that firstborn infants have significant disadvantages in birth weight, length of gestation, height, weight-for-gestational-age and weight-for-height compared with infants at higher birth orders. There are also notable health disadvantages for infants born to mothers younger than 18. On average, first-time mothers aged 21 or younger are shorter than older first-time mothers, weigh less, are less educated, have fewer financial assets and are less likely to have received modern prenatal care. Even in the presence of controls for these attributes, however, firstborn infants born to women younger than 18 are of lower birth weight, shorter gestation, shorter height, and lower weight-for-height than are those born to women aged 22 or older; health disadvantages for infants born to women aged 18-21 are no longer statistically significant, though, when the effects of maternal characteristics are controlled. (PHILIPPINES, FIRST BIRTH, MATERNAL AGE)
93.76.15 - English - Ricardo VERNON, Population Council (Mexico), José Rubén LOPEZ-CANALES, José ARNULFO CARCAMO, Obstetrics and Gynecology Department, Hospital Materno-Infantil, Tegucigalpa (Honduras), and Judith GALINDO
The Impact of a Perinatal Reproductive Health Program in Honduras (p. 103-109)
To improve perinatal service delivery at the Hospital Materno-infantil in Tegucigalpa, the Honduran Social Security System created a reproductive health program with five main components: a prenatal education program, a reproductive health counseling service, an expansion of contraceptive options offered in the postpartum period, a postpartum clinic for women to visit on the 40th day after birth, and an improved perinatal data collection system. The prenatal education program, attended by approximately half of the more than 6,000 women who delivered at the hospital during a 15-month period, significantly increased the women's knowledge about such topics as reproductive risk factors, warning signs during pregnancy, breastfeeding and infant care. Rates of acceptance of postpartum family planning increased significantly and rapidly, from 9% of women who delivered in December 1990 to 47% in February 1992. Over a 10-month period, the number of women seeking family planning and reproductive health counseling increased from 33 per month to 296 per month. The proportion of women who returned for a checkup at 40 days postpartum increased from about 15% to almost 40%. (HONDURAS, MATERNAL AND CHILD HEALTH, FAMILY PLANNING PROGRAMMES)
1993 - VOLUME 19, NUMBER 4
93.76.16 - English - S. Irudaya RAJAN, U.S. MISHRA, Global Training Program, Population and Development, Centre for Development Studies, Kerala (India), and Mala RAMANATHAN
The Two-Child Family in India: Is It Realistic? (p. 125-128)
The concept of "extra births" - third or higher order births that occur among women before they are protected by sterilization - is used to analyze the gap between prevailing fertility levels in India and a two-child family norm. Data from 1981-1987 show that the average age at sterilization in India is approximately 30 years, and women, on average, have their second child at ages 23-24. The resulting 6-7 years of exposure to the risk of higher order childbearing results in 1.5 extra births per woman. Only four states - Kerala, Tamil Nadu, Gujarat and West Bengal - have already attained or are on the verge of attaining a norm of two children per family, either by lengthening birth intervals or lowering the age at sterilization. The remaining 13 states still have far to go to shorten the period of unprotected exposure to higher order childbearing that occurs between reaching parity two and being protected from further childbearing by sterilization. (INDIA, FAMILY SIZE, SEXUAL STERILIZATION)
93.76.17 - English - Dov CHERNICHOVSKY, Health Economics and Administration Unit, Center for Health Sciences, and Jon ANSON, Department of Social Work, Ben Gurion University of Negev, Beer Sheva (Israel)
Cost Recovery and the True Cost-effectiveness of Contraceptive Provision (p. 129-133)
Traditional assessments of the impact and cost-effectiveness of various contraceptive methods, using couple-years of protection (CYPs) per dollar spent, do not accurately measure the level of protection offered by each method. An alternative measure - adjusted CYPs - that takes into account the relative risk of pregnancy among the users of each method is proposed here. Calculations show how cost recovery and reinvestment of the proceeds from family planning programs lead to the cross-subsidization of methods. In general, the more subsidized contraceptive methods are supported by the less subsidized methods. An examination of data from Colombia's Profamilia family planning program indicates that because of the differences in the relative risk of pregnancy of women of different ages, sterilization, the most effective contraceptive method, is not necessarily the most cost-effective method in terms of the number of CYPs it provides per unit cost. (COLOMBIA, FAMILY PLANNING PROGRAMMES, FINANCING, PROGRAMME EVALUATION)
93.76.18 - English - Susheela SINGH and Deirdre WULF, The Alan Guttmacher Institute, 111 Fifth Av., New York, NY 10003 (U.S.A.)
The Likelihood of Induced Abortion among Women Hospitalized for Abortion Complications in Four Latin American Countries (p. 134-141)
Application of the World Health Organization (WHO) method of class 8,589 women hospitalized for abortion complications in Bolivia, Colombia, Peru and Venezuela reveals that 67% of all such women may have experienced their complications as the result of an induced abortion, compared with 9% reported by the women. According to WHO criteria, 13% of the women in these four countries are certain to have had an induced abortion, 6% probably have had one and 49% possibly have had one. Unmarried women are significantly more likely than married women to be classified as certain to have had an induced abortion (24% vs. 10%). Compared with women who are likely to have had a spontaneous abortion, those who are likely to have had an induced abortion tend to have more children (16% vs. 2% had had five or more live births) and to be older (39% vs. 22% were aged 30 or older). Among women likely to have been hospitalized for induced abortion complications, 40% had been using a contraceptive method at the time of conception and 31% said they had had at least one previous abortion. About 23% of women who are likely to have had an induced abortion had a septic infection, 31% were at 13 weeks or more gestation and about 50% stayed in the hospital for two days or more. (LATIN AMERICA, INDUCED ABORTION)
Back to home page